Trial reportIntensive care medicine2013
Patient-ventilator synchrony and sleep quality with proportional assist and pressure support ventilation.
Trial report in Intensive care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02801994 (Impact of Proportional Assisted Ventilation on Dyspnea and Asynchrony in Mechanically Ventilated Patients), which is not on this map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Impact of Proportional Assisted Ventilation on Dyspnea and Asynchrony in Mechanically Ventilated Patients
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 88 citations in OpenAlex.
- A Systematic Review of Sleep Measurement in Critically Ill Patients.Frontiers in neurology · 2020Pooled it
- A meta-analysis of sleep-promoting interventions during critical illness.The American journal of medicine · 2015Pooled it
- Challenges and strategies for the identification and correction of patient-ventilator asynchronies in daily practice: a scoping review.Acute and critical care · 2026Article
- Nocturnal Pressure Support Ventilation: Truth or Dare?Respiratory care · 2024Article
- Reply to Letter to Editor Concerning "Nocturnal Pressure Controlled Ventilation Improves Sleep Efficiency in Patients Receiving Mechanical Ventilation".Respiratory care · 2024Article
- Induction of subject-ventilator asynchrony by variation of respiratory parameters in a lung injury model in pigs.Respiratory research · 2024Article
- Survey of Ventilator Waveform Interpretation Among ICU Professionals.Respiratory care · 2024Article
- Sleep Assessment in Critically Ill Patients With Acute Hypoxemic Respiratory Failure.Respiratory care · 2023Observational
- Sleep during and following critical illness: A narrative review.World journal of critical care medicine · 2023Review
- Causes, Consequences, and Treatments of Sleep and Circadian Disruption in the ICU: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2023Article
- Neurally Adjusted Ventilatory Assist in Acute Respiratory Failure-A Narrative Review.Journal of clinical medicine · 2022Review
- Methods of liberation from mechanical ventilation: Which one is best?Frontiers in medicine · 2022Article
- Dexmedetomidine Improves Non-rapid Eye Movement Stage 2 Sleep in Children in the Intensive Care Unit on the First Night After Laparoscopic Surgery.Frontiers in pediatrics · 2022Article
- Proportional assist ventilation relieves clinically significant dyspnea in critically ill ventilated patients.Annals of intensive care · 2021Article
- Refractory ineffective triggering during pressure support ventilation: effect of proportional assist ventilation with load-adjustable gain factors.Annals of intensive care · 2021Article
- Patient-Ventilator Dyssynchrony in Critically Ill Patients.Journal of clinical medicine · 2021Review
- Etiology, incidence, and outcomes of patient-ventilator asynchrony in critically-ill patients undergoing invasive mechanical ventilation.Scientific reports · 2021Article
- Updated Perspectives on the Management of Sleep Disorders in the Intensive Care Unit.Nature and science of sleep · 2021Review
- Methods of Weaning From Mechanical Ventilation in Adult: A Network Meta-Analysis.Frontiers in medicine · 2021Article
- Proportional modes of ventilation: technology to assist physiology.Intensive care medicine · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine patient-ventilator asynchrony and sleep quality in non-sedated critically ill patients ventilated with proportional assist ventilation with load adjustable gain factors (PAV+) and pressure support (PSV).
methodsThis was a randomized crossover physiological study conducted in an adult ICU at a tertiary hospital. Patients who exhibited patient-ventilator asynchrony on PSV were selected. Polysomnography was performed in these patients over 24 h, during which respiratory variables were continuously recorded. During the study period, each patient was randomized to receive alternating 4-h periods of PSV and PAV+ equally distributed during the day and night. Sleep architecture was analyzed manually using predetermined criteria. Patient-ventilator asynchrony was evaluated breath by breath using the flow-time and airway pressure-time waveforms.
resultsFourteen patients were studied. The majority (85.7 %) had either acute exacerbation of COPD as admission diagnosis or COPD as comorbidity. During sleep, compared to PSV, PAV+ significantly reduced the patient-ventilator asynchrony events per hour of sleep [5 (1-17) vs. 40 (4-443), p = 0.02, median (25-75th interquartile range)]. Compared to PSV, PAV+ was associated with slightly but significantly greater sleep fragmentation [18.8 (13.1-33.1) versus 18.1 (7.0-22.8) events/h, p = 0.01] and less REM sleep [0.0 % (0.0-8.4) vs. 5.8 % (0.0-21.9), p = 0.02).
conclusionsPAV+ failed to improve sleep in mechanically ventilated patients despite the fact that this mode was associated with better synchrony between the patient and ventilator. These results do not support the hypothesis that patient-ventilator synchrony plays a central role in determining sleep quality in this group of patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.