Validation of a Proposed Algorithm for Assistance Titration During Proportional Assist Ventilation With Load-Adjustable Gain Factors

Validation of a Proposed Algorithm for Assistance Titration During Proportional Assist Ventilation With Load-Adjustable Gain Factors

The present study aimed to validate a recently proposed algorithm for assistance titration during proportional assist ventilation with load-adjustable gain factors, based on a noninvasive estimation of maximum inspiratory pressure (peak P ) and inspiratory effort (pressure-time product [PTP] peak P...

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Bibliographic Details
Published in:Respiratory care Vol. 65; no. 1; pp. 36 - 44
Main Authors: Amargiannitakis, Vasilios, Gialamas, Ioannis, Pediaditis, Emmanouil, Soundoulounaki, Stella, Prinianakis, Georgios, Vaporidi, Katerina, Akoumianaki, Evangelia, Proklou, Athanasia, Alexopoulou, Christina, Georgopoulos, Dimitrios, Kondili, Eumorfia
Format: Journal Article
Language:English
Published: United States Daedalus Enterprises, Inc 01-01-2020
Subjects:
Algorithms
Backup software
Comparative analysis
Greece
inspiratory muscles output
proportional assist ventilation
titration
assistance
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Summary:The present study aimed to validate a recently proposed algorithm for assistance titration during proportional assist ventilation with load-adjustable gain factors, based on a noninvasive estimation of maximum inspiratory pressure (peak P ) and inspiratory effort (pressure-time product [PTP] peak P ). Retrospective analysis of the recordings obtained from 26 subjects ventilated on proportional assist ventilation with load-adjustable gain factors under different conditions, each considered as an experimental case. The estimated inspiratory output (peak P ) and effort (PTP-peak P ) were compared with the actual-determined by the measurement of transdiaphragmatic pressure- and the derived PTP. Validation of the algorithm was performed by assessing the accuracy of peak P in predicting the actual inspiratory muscle effort and indicating the appropriate level of assist. In the 63 experimental cases analyzed, a limited agreement was observed between the estimated and the actual inspiratory muscle pressure (-11 to 10 cm H O) and effort (-82 to 125 cm H O × s/min). The sensitivity and specificity of peak P to predict the range of the actual inspiratory effort was 81.2% and 58.1%, respectively. In 49% of experimental cases, the level of assist indicated by the algorithm differed from that indicated by the transdiaphragmatic pressure and PTP. The proposed algorithm had limited accuracy in estimating inspiratory muscle effort and with indicating the appropriate level of assist.
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ISSN:0020-1324
1943-3654
DOI:10.4187/respcare.06988