Automatic tube compensation combined with pressure support ventilation - improved work of breathing pattern and less work

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Introduction

Liberation from mechanical ventilation may be difficult due to resistive properties of the endotracheal tube (ETT), which increases work of breathing. PSV alone may not overcome this problem as the increased resistance largely limits expiratory gas flow–inspiration and expiration. The benefits of combining ATC with PSV have not been assessed.

Method

We included 34 patients ventilated with three levels of PSV (<15, 15–20, 20–30 CMH₂O). ATC with100% conpensation was then added for 30 min, stopped for 30 min and re–instituted for 30 min. At the end of each period we measured respiratory rate (RR), tidal volume (TV), minute ventilation (MV), PEEPi, HR, VO₂, VCO₂ and energy expenditure (EE).

Results are given as median and ±SD

No significant differences were found for the parameters studied at other levels of PSV.

Conclusions

The addition of ATC to low levels of PSV (<15 CM of water) results in improved breathing patterns with metabolic benefits to the patient.

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