Potential advantages and disadvantages

Proportional assist ventilation allows complete control of ventilation when demands change and respiratory system mechanics are stable (i.e. sepsis, acidosis, etc.). Additionally, there are no preset limits to the degree of assist (the harder the patient pulls, the harder the machine pushes). These characteristics may render this ventilatory mode very comfortable for the patient.

Disadvantages are related to the lack of assistance when intrinsic PEEP is present. This has to be overcome by the respiratory muscles before initiating inspiratory flow, and thus is not 'seen' by the ventilator as a muscular pressure. For a correct set-up of proportional assist ventilation, the elastance and resistance of the respiratory system must be measured to adjust the ventilator gain settings adequately. Furthermore, during proportional assist ventilation it is mandatory that patients maintain a normal respiratory output. Changes in breathing pattern may be difficult to evaluate. Finally, if inspiratory leaks exist, airway pressure will increase because there is an overestimation of the volume and flow received by the patient.

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Sleep Apnea

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