ArticleAnnals of intensive care2021
Proportional assist ventilation relieves clinically significant dyspnea in critically ill ventilated patients.
Article in Annals of intensive care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Surface electromyography signal processing and evaluation on respiratory muscles of critically ill patients: A systematic review.PloS one · 2023Pooled it
- "Evaluation of Different Inspiratory Efforts in a Pediatric Model of Healthy Lung and Pediatric Acute Respiratory Distress Syndrome During Optimized Pressure Support Ventilation and Proportional Assist Ventilation Plus (PAV+): A Bench Study.Pediatric pulmonology · 2025Article
- Breathlessness assessment, management and impact in the intensive care unit: a rapid review and narrative synthesis.Annals of intensive care · 2024Review
- Dyspnoea in acutely ill mechanically ventilated adult patients: an ERS/ESICM statement.Intensive care medicine · 2024Article
- Managing respiratory muscle weakness during weaning from invasive ventilation.European respiratory review : an official journal of the European Respiratory Society · 2023Article
- DYSPNEA AND MECHANICAL VENTILATION: APPLYING PHYSIOLOGY TO GUIDE THERAPY.Transactions of the American Clinical and Climatological Association · 2023Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDyspnea is common and often severe symptom in mechanically ventilated patients. Proportional assist ventilation (PAV) is an assist ventilatory mode that adjusts the level of assistance to the activity of respiratory muscles. We hypothesized that PAV reduce dyspnea compared to pressure support ventilation (PSV). PATIENTS AND
methodsMechanically ventilated patients with clinically significant dyspnea were included. Dyspnea intensity was assessed by the Dyspnea-Visual Analog Scale (D-VAS) and the Intensive Care-Respiratory Distress Observation Scale (IC-RDOS) at inclusion (PSV-Baseline), after personalization of ventilator settings in order to minimize dyspnea (PSV-Personalization), and after switch to PAV. Respiratory drive was assessed by record of electromyographic activity of inspiratory muscles, the proportion of asynchrony was analyzed.
resultsThirty-four patients were included (73% males, median age of 66 [57-77] years). The D-VAS score was lower with PSV-Personalization (37 mm [20‒55]) and PAV (31 mm [14‒45]) than with PSV-Baseline (62 mm [28‒76]) (p < 0.05). The IC-RDOS score was lower with PAV (4.2 [2.4‒4.7]) and PSV-Personalization (4.4 [2.4‒4.9]) than with PSV-Baseline (4.8 [4.1‒6.5]) (p < 0.05). The electromyographic activity of parasternal intercostal muscles was lower with PAV and PSV-Personalization than with PSV-Baseline. The asynchrony index was lower with PAV (0% [0‒0.55]) than with PSV-Baseline and PSV-Personalization (0.68% [0‒2.28] and 0.60% [0.31‒1.41], respectively) (p < 0.05).
conclusionIn mechanically ventilated patients exhibiting clinically significant dyspnea with PSV, personalization of PSV settings and PAV results in not different decreased dyspnea and activity of muscles to a similar degree, even though PAV was able to reduce asynchrony more effectively.
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