Proportional Pressure Support (PPS) has shown to reduce asynchronies and duration of ventilation
—- PPS (Proportional Pressure Support) is a proportional mode that was associated with a reduction in incidence with AI >10%1 and duration of ventilation2 when compared with PSV (Pressure Support Ventilation).
- Patient-ventilator asynchrony is considered high when the Asynchrony Index (AI) is >10%3, and it is associated with longer ventilation times4 and higher mortality rates5.
- While the support during PSV always remains constant, in PPS, support is provided proportionally. This proportional delivery results in support being provided only when it is needed.
Proportional Pressure Support: How does it work?
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Contact our team to find more about Proportional Pressure Support and how it can reduce asynchronies and the duration of ventilation.
Patient comfort – a clinical priority
Up to 60 – 80% of mechanically ventilated patients in the ICU are affected by delirium6
We focus on
- Allowing variability of spontaneous breathing, avoiding asynchronies
- Improving sleep quality
- Matching individual ventilation requirements
Improve sleep quality
Proportional ventilation resulted in fewer patient-ventilator asynchronies and better quality of sleep compared to pressure support ventilation7.
- Lower patient-ventilator asynchronies per hour at 24±15 vs. 53±598.
- Fewer awakenings per hour at 3.5 (range 0-24) vs. 5.5 (range 1-24)9.
PPS, efficient weaning, and more
—From a study of 87 ICU patients10, compared to patients on ventilators using the common ASB (Assisted Spontaneous Breath) ventilation mode, patients on ventilators using PPS (Proportional Pressure Support) had
- Reduced incidence of high man-machine confrontation from 27% to 9%11,
- Reduced failure rate of first spontaneous breathing trial (SBT) from 23% to 7%12, and
- Shortened ventilator weaning time from 51±38 to 13±14 hours13.
Dräger Evita V600
- Increased variability in spontaneous breathing through Proportional Pressure Support
- Automatic weaning with SmartCare
- Recruitment tools (e.g. QuickSet® and PressureLink) and therapy decision support with breath-by-breath trends (PEEP, EIP, Vt, Cdyn)
- Focus on end-expiratory lung volume with PC-APRV with AutoRelease
- Facilitating spontaneous breathing through “room to breathe concept” with e.g. AutoFlow or Volume Guarantee
Quick set up guide: Proportional Pressure Support (PPS)
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Selangor Darul Ehsan, Malaysia
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References
—1. Kataoka J, Kuriyama A, Norisue Y, Fujitani S. Proportional modes versus pressure support ventilation: a systematic review and meta-analysis. Ann Intensive Care. 2018 Dec 10;8(1):123. doi: 10.1186/s13613-018-0470-y. PMID: 30535648; PMCID: PMC6288104.
2. Ibid
3. Blanch L, Villagra A, Sales B, Montanya J, Lucangelo U, Luján M, et al. Asynchronies during mechanical ventilation are associated with mortality. Intensive Care Med 2015;41:633-41.
4. Ibid
5. Ibid
6. Brummel NE, Girard TD. Preventing delirium in the intensive care unit. Crit Care Clin. 2013 Jan;29(1):51-65. doi: 10.1016/j.ccc.2012.10.007. PMID: 23182527; PMCID: PMC
8. Ibid
9. Ibid
10. Yin C et al., Comparison of the effect of CPAP+PPS mode and CPAP+ASB mode in weaning on acute exacerbation of chronic obstructive pulmonary disease patients, Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2018 Oct;30(10):939-942. doi: 10.3760/cma.j.issn.2095-4352.2018.10.006.
11. Ibid
12. Ibid
13. Ibid