SynthesisFrontiers in medicine2026
Effect of proportional assist ventilation plus versus pressure support ventilation on successful weaning in critically ill adults: a systematic review, meta-analysis, and trial sequential analysis.
Synthesis in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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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.
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Authors and funding
10 authors.
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Abstract
Background: Proportional assist ventilation plus (PAV+) and pressure support ventilation (PSV) are commonly employed ventilatory modes during the weaning process from mechanical ventilation in critically ill adult patients. Proportional assist ventilation plus delivers assistance proportional to the patient's inspiratory effort, thereby enhancing patient-ventilator synchrony and reducing the work of breathing. However, the efficacy of proportional assist ventilation in facilitating successful weaning remains a matter of debate. Methods: A comprehensive search was conducted in CENTRAL, PubMed, MEDLINE, Web of Science, Embase, and ClinicalTrials.gov from inception to October 1, 2025 We included randomized controlled trials comparing proportional assist ventilation plus with pressure support ventilation in adult patients (≥18 years) who underwent invasive mechanical ventilation for at least 24 h prior to weaning. The primary outcome was the rate of successful weaning, while secondary outcomes included reintubation rate, ICU and hospital mortality, ICU length of stay and duration of weaning. Trial sequential analysis and subgroup analyses based on clinical intent (spontaneous breathing trial vs. continuous weaning) were integrated to enhance the robustness of the findings. Results: In seven RCTs ( Conclusion: Proportional assist ventilation plus improved weaning success compared with pressure support ventilation. This benefit remained robust in sensitivity analyses excluding spontaneous breathing trial studies. These findings suggest Proportional assist ventilation plus is a promising weaning mode, but further research is needed to optimize its implementation. Systematic review registration: PROSPERO, CRD420251170692.
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