Regulation of Inspiratory Neuromuscular Output during Synchronized Intermittent Mechanical Ventilation

  title={Regulation of Inspiratory Neuromuscular Output during Synchronized Intermittent Mechanical Ventilation},
  author={Christophe Imsand and François Feihl and Cl. Perret and Jean-William Fitting},
BackgroundIn synchronized intermittent mandatory ventilation, it is generally accepted that the work of the inspiratory muscles is decreased by the ventilator so that their activity can be modulated by the frequency of assisted breaths. We examined the validity of this concept, which recently has been questioned. MethodsWe studied five patients receiving synchronized intermittent mandatory ventilation because of an acute exacerbation of chronic obstructive pulmonary disease. The level of… 
Prolonged Neural Expiratory Time Induced by Mechanical Ventilation in Infants
Mechanical ventilation may interfere with the spontaneous breathing pattern in infants because they have strong reflexes that play a large role in the control of breathing. This study aimed to answer
Chapter 57 – Ventilator Support
Adapting ventilator strategies that account for abnormalities, such as controlled hypoventilation in acute asthma or the application of external PEEP in patients with COPD, may decrease morbidity and possibly improve patient outcome.
Time course evolution of ventilatory responses to inspiratory unloading in patients.
The decrease in ventilatory drive associated with PSV takes place from the first breath onwards but requires six to eight breaths to be fully achieved, and during BIPAP, assisted breaths following spontaneous breaths are characterized by an enhanced inspiratory efficiency.
Effects of chemical feedback on respiratory motor and ventilatory output during different modes of assisted mechanical ventilation.
The mode of mechanical ventilation modifies the effects of chemical feedback on respiratory motor and ventilatory output and neuroventilatory coupling was better preserved with proportional assist ventilation than with pressure support and assist-volume control ventilation.
Weaning from ventilatory support.
Two recent clinical trials suggest that ventilatory management has a major influence on the outcome of weaning from mechanical ventilation in difficult-to-wean patients.
Control of breathing in mechanically ventilated patients.
The response of ventilator to patient effort, and that of patient effort to ventilATOR-delivered breath are inevitably the two components of control of breathing during mechanical ventilation; the ventilatory output is the final expression of the interaction between these two components.
Metabolic and Respiratory Variables during Pressure Support versus Synchronized Intermittent Mandatory Ventilation
Assessment in non-tracheostomized patients without known obstructive pulmonary disease receiving short-term mechanical ventilation in the intensive care unit resulted in smaller changes in metabolic and respiratory variables compared with equivalent changes in the level of volume-cycled SIMV support.
Effect of Synchronized Intermittent Mandatory Ventilation on Respiratory Workload in Infants after Cardiac Surgery
When the load to breathing was increased progressively by decreasing the SIMV rate in post–cardiac surgery infants, tidal volume and spontaneous respiratory rate both increased.
Comparing the Effect of Adaptive Support Ventilation (ASV) and Synchronized Intermittent Mandatory Ventilation (SIMV) on Respiratory Parameters in Neurosurgical ICU Patients
ASV mode compared with SIMV mode can lead to improve lung compliance and respiratory dead space, and the mean value for dynamic compliance had no significant difference in the two types of ventilation, it was better in ASV mode.
Patient-Ventilator Interactions: Optimizing Conventional Ventilation Modes
Current ventilation modes have a number of features that can monitor and enhance synchrony, including adjustment of the trigger variable, the use of pressure-targeted versus fixed-flow- targeted breaths, and manipulations of the cycle variable.