| Title |
Can proportional ventilation modes facilitate exercise in critically ill patients? A physiological cross-over study
|
|---|---|
| Published in |
Annals of Intensive Care, June 2017
|
| DOI | 10.1186/s13613-017-0289-y |
| Pubmed ID | |
| Authors |
Evangelia Akoumianaki, Nicolas Dousse, Aissam Lyazidi, Jean-Claude Lefebvre, Severine Graf, Ricardo Luiz Cordioli, Nathalie Rey, Jean-Christophe Marie Richard, Laurent Brochard |
| Abstract |
Early exercise of critically ill patients may have beneficial effects on muscle strength, mass and systemic inflammation. During pressure support ventilation (PSV), a mismatch between demand and assist could increase work of breathing and limit exercise. A better exercise tolerance is possible with a proportional mode of ventilation (Proportional Assist Ventilation, PAV+ and Neurally Adjusted Ventilatory Assist, NAVA). We examined whether, in critically ill patients, PSV and proportional ventilation have different effects on respiratory muscles unloading and work efficiency during exercise. Prospective pilot randomized cross-over study performed in a medico-surgical ICU. Patients requiring mechanical ventilation >48 h were enrolled. At initiation, the patients underwent an incremental workload test on a cycloergometer to determine the maximum level capacity. The next day, 2 15-min exercise, at 60% of the maximum capacity, were performed while patients were randomly ventilated with PSV and PAV+ or NAVA. The change in oxygen consumption (ΔVO2, indirect calorimetry) and the work efficiency (ratio of ΔVO2 per mean power) were computed. Ten patients were examined, 6 ventilated with PSV/PAV+ and 4 with PSV/NAVA. Despite the same mean inspiratory pressure at baseline between the modes, baseline VO2 (median, IQR) was higher during proportional ventilation (301 ml/min, 270-342) compared to PSV (249 ml/min, 206-353). Exercise with PSV was associated with a significant increase in VO2 (ΔVO2, median, IQR) (77.6 ml/min, 59.9-96.5), while VO2 did not significantly change during exercise with proportional modes (46.3 ml/min, 5.7-63.7, p < 0.05). As a result, exercise with proportional modes was associated with a better work efficiency than with PSV. The ventilator modes did not affect patient's dyspnea, limb fatigue, distance, hemodynamics and breathing pattern. Proportional ventilation during exercise results in higher work efficiency and less increase in VO2 compared to ventilation with PSV. These preliminary findings suggest that proportional ventilation could enhance the training effect and facilitate rehabilitation. |
X Demographics
The data shown below were collected from the profiles of 39 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 4 | 10% |
| United States | 4 | 10% |
| Brazil | 3 | 8% |
| Spain | 3 | 8% |
| Chile | 3 | 8% |
| Argentina | 2 | 5% |
| Australia | 2 | 5% |
| Colombia | 2 | 5% |
| Canada | 1 | 3% |
| Other | 1 | 3% |
| Unknown | 14 | 36% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 30 | 77% |
| Scientists | 4 | 10% |
| Practitioners (doctors, other healthcare professionals) | 4 | 10% |
| Science communicators (journalists, bloggers, editors) | 1 | 3% |
Mendeley readers
The data shown below were compiled from readership statistics for 81 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 81 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 9 | 11% |
| Student > Postgraduate | 9 | 11% |
| Student > Master | 9 | 11% |
| Student > Bachelor | 9 | 11% |
| Student > Ph. D. Student | 6 | 7% |
| Other | 16 | 20% |
| Unknown | 23 | 28% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 31 | 38% |
| Nursing and Health Professions | 15 | 19% |
| Sports and Recreations | 6 | 7% |
| Biochemistry, Genetics and Molecular Biology | 1 | 1% |
| Economics, Econometrics and Finance | 1 | 1% |
| Other | 2 | 2% |
| Unknown | 25 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 26. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 September 2020.
All research outputs
#1,480,039
of 25,382,250 outputs
Outputs from Annals of Intensive Care
#167
of 1,190 outputs
Outputs of similar age
#28,469
of 322,841 outputs
Outputs of similar age from Annals of Intensive Care
#4
of 29 outputs
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So far Altmetric has tracked 1,190 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 18.2. This one has done well, scoring higher than 86% of its peers.
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We're also able to compare this research output to 29 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 89% of its contemporaries.