Proportional assist ventilation

Abstract

The idea of proportional assist ventilation, in which the patient himself sets the respiratory pattern — the frequency and depth of breathing — was suggested in 1992, but has not yet found widespread practical application. One of the possible reasons for this is the complex algorithm of regime adjustment on first-generation respiratory devices. Over time, the accumulated body of information on the early damage of the diaphragm because of its atrophy in patients on respiratory support formed the basis of the awareness of the importance of maintaining the physiological state of the diaphragm during artificial lung ventilation and led to the emergence of the term “myotrauma”.At the turn the 21st century, the idea of the maximum possible preservation of spontaneous breathing of the patient during mechanical lung ventilation realized in the formation of the concept of “diaphragm-protective ventilation”. The need for further development of assisted lung ventilation technologies designed to reduce the risk of diaphragm damage, the frequency of asynchrony in the pair “respirator-patient”, and to facilitate the process of weaning of the patient from the artificial lung ventilation became apparent. This article, based on scientific literature and own clinical experience of using proportional ventilation, describes the peculiarities of regime adjustment on different respirators, places the accents necessary for successful practical use of proportional lung ventilation. Describes key conditions for its use, advantages and limitations.