What is Pressure Support Ventilation?

It is a common phenomenon to open windows during the day. You will also install air conditioners. We do this involuntarily recognizing the essence of proper ventilation. One tip that will guide you to choosing a new house is ventilation. Ventilation refers to the process by which fresh air gets into the house. Our bodies need an abundance of fresh air to work optimally.

Therefore, the process of ventilation can be enhanced using various supports. In respiratory physiology, ventilation refers to the process by which air gets exchanged within the lungs with the ambient air. We can further talk of alveolar ventilation and pulmonary ventilation depending on the site of air exchange. Ideally, ventilation should be self-regulated. However, due to inevitable circumstances, there can be a need for assistance.

Continuous spontaneous ventilation

Do you decide on when to breathe in or out? You do it unaware and effortlessly. This is termed natural breathing. The respiratory muscles contract and relaxes unconsciously to move air in and out of the lungs. In spontaneous breathing, a normal human being will make an average of 18 breaths every minute. Timing, amount and quality are never controlled.

The pattern remains unaltered until intrusion by external offending factors. Several factors can cause a reduction in the rate of ventilation or entirely halt the process. As such mechanical ventilation is needed to support patients in critical conditions. Therefore, we can have assist modes, control modes and assist-control modes of mechanical ventilation, or even use raised access floors from Airfixture.

Mechanical ventilation is an air exchange that is made possible with the aid of an external means. The external input can either trigger, regulate or modify the ventilation rates. It is classified either as negative pressure or positive pressure ventilation regarding the intriguing effect and resultant effects.

Pressure support ventilation

Also known as pressure support, PSV is the augmentation of spontaneous ventilation by a positive airway pressure. It remains a mechanical mode of ventilation since the patient initiates the process and the ventilator work as per the preset pressure value. Also, the patient remains in control of their tidal rate and respiratory rates. The patient must initiate most of the breathing functions. It can be termed non-triggered effort, and the ventilator only helps in the execution of intended actions within desired limits.

Pressure support ventilation will act to supplement breathing in cases of deficiencies. The breath is patient-triggered and controlled. It often involves a positive pressure wave that synchronizes with the inspiratory efforts and intents of the patient. As such, it can be initiated or terminated by the patient at will. The machine will act to add pressure to the desired levels with each breath. A combination of the PSV and Volume guarantee will grant the patient full control over the inspiratory time and rates. PSV will only enhance your will and ensure the realization of your intentions. There is a unique combination of simultaneous spontaneous breathing and mechanical breathing at the center stage of PSV.

Roles of Pressure Support Ventilation

You will widely find PSVs in intensive care units. Most of the patients in the ICUs have a preserved respiratory drive, and support is sufficient to keep them alive. The partial mode of ventilator support is particularly important in limiting the need for sedation in critically ill patients. As a result, you can avoid disuse atrophy of the respiratory muscles often associated with controlled ventilation. The muscles are kept active and regaining normal function is much more comfortable. It can be used during the stable ventilator support period as well as a weaning method.

PSV is a preferred choice among the different methods of ventilator management in patients that don’t have severe respiratory failure. The only consideration is whether the patient has an adequate respiratory drive or not. It will maintain the breathing function while at the same time reduce the work of breathing. Straining during breathing can worsen respiratory failure. However, breathing should not be wholly dropped. PSVs will improve patient’s comfort when they ventilate as well as reduce risks that may occur when one breath in respiratory failure. Common risks include cardiovascular effects and barotrauma.

How does Pressure support ventilation work?

PSV as a form of ventilatory support ensures patient’s control and comfort during breathing in respiratory distress. How is this possible? The patient will be able to control the respiratory rate, inspiratory flow and expiration ratio by a 4 stage process.

1. Trigger stage- involves initiation and recognition of the beginning of an inspiration cycle. The patient will trigger the process by creating a negative or positive pressure. After that, the ventilator will switch to an inspiratory mode allowing air to flow at the preset levels.
2. Pressurization for the time of spontaneous inspiration- during this phase, the pressure level is synchronized to match the needs of the body. Pressure allows the delivery of air to the various organs without straining the body.
3. Recognition of end of inspiration and start of expiration- after reaching a given threshold; usually 25% of peak flow rate, inspiration stops. The homeostatic processes trigger expiration start. During exhalation, positive end-expiratory pressure gets exerted by the ventilator.
4. The complete expiration process to remove waste gases.

The process is self-regulated by the patient, and the PSV has no role in starting the process, but it works in harmony with the respiratory drive. Variations in tidal volume is a major concern that will influence the effectiveness of the ventilator.

Advantages of Pressure support ventilator

PSV have been useful in helping patients with respiratory issues since their introduction. They are an essential support device for patients having intact respiratory drive. Every healthcare facility should have a Pressure support ventilator to help preserve life. Some of the notable benefits of PSV over other mechanical ventilatory techniques include;

• It is a comfortable method of ventilation for conscious patients. It is a non-invasive process thus no pains in attaching the devices. You can connect then using face masks.
• PSV can be used to overcome airway restrictions and resistances.  Airway resistance due to various causes can impair life thus the need to free up using the PSV.
• It will ensure you don’t overwork your respiratory system.
• Pressure supports will find use in patients having difficulty weaning.
• It is an economical ventilator management method since it reduces the cost of oxygen in breathing.
• You can achieve better synchrony between the ventilator and the patient’s breathing.
• There is a reduced need to sedate the patient during treatment.