A comparative evaluation of pressure-triggering and flow-triggering in pressure support ventilation (PSV) for neonates using an animal model

• Published in: Anaesthesia and intensive care 1995-06, Vol.23 (3), p.302-306
• Main Authors: UCHIYAMA, A, IMANAKA, H, TAENAKA, N, NAKANO, S, FUJINO, Y, YOSHIYA, I
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Biological and medical sciences; Diaphragm - physiology; Disease Models, Animal; Electromyography; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Esophagus - physiology; Evaluation Studies as Topic; Humans; Infant, Newborn; Inhalation; Intensive care medicine; Medical sciences; Oxygen - administration & dosage; Positive-Pressure Respiration - methods; Pressure; Pulmonary Ventilation - physiology; Rabbits; Rheology; Tidal Volume; Time Factors; Work of Breathing - physiology
• ISSN: 0310-057X; 1448-0271
• DOI: 10.1177/0310057x9502300306

The triggering system in pressure support ventilation needs to respond rapidly, especially in neonates. The aim of this study was to compare the effects of flow-triggered and pressure-triggered pressure support ventilation on neonatal mechanical ventilation using an animal model. Respiratory flow, airway pressure, oesophageal pressure, and diaphragmatic electromyogram were measured during pressure support ventilation in five anaesthetized rabbits. The animals were connected to a VIPBIRD (Bird, U.S.A.) (CPAP mode, pressure support ventilation, 5 cm H2O and PEEP 0 cm H2O). Flow-triggering sensitivity was set at 0.2l/min, 0.5l/min, 1.01l/min, or 1.5l/min. Pressure-triggering sensitivity was set at -1.0 cm H2O. Shorter trigger delay and longer pressure support time were observed in flow-triggering. There was also less diaphragmatic activity in flow-triggering as evidenced by the amplitude of integrated diaphragmatic electromyogram and negative deflection of oesophageal pressure. The findings suggest that flow-triggering will prove superior to pressure-triggering in pressure support ventilation for neonates.