What are the advantages of pressure-support ventilation (PSV) to wean patients from mechanical ventilation?

Updated: Apr 11, 2019
  • Author: Christopher D Jackson, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Answer

In PSV weaning, all breaths are spontaneous and combined with enough pressure support to ensure that each breath generates a reasonable tidal volume. Pressure support lowers the work of breathing for the patient. Weaning is performed by gradually decreasing the amount of pressure support and by transferring an increased proportion of the work to the patient. This transfer is continued until the pressure support approaches 5-6 cm water. When the patient can tolerate this level of ventilatory support, extubation is usually successful. Studies have demonstrated that PSV weaning reduces the number of days on mechanical ventilation compared with SIMV alone. PSV can be used in conjunction with SIMV when a patient is weaned from mechanical ventilation (see image below). The coupling of these 2 modes is an especially attractive option in frail patients with underlying chronic illnesses.

The pressure, volume, and flow to time waveforms f The pressure, volume, and flow to time waveforms for synchronized intermittent mandatory ventilation (SIMV) with pressure-support ventilation.

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