Respiratory muscle unloading during auto-adaptive non-invasive ventilation

Respir Med. 2009 Nov;103(11):1706-12. doi: 10.1016/j.rmed.2009.05.003. Epub 2009 Jun 7.

Abstract

Rationale: Non-invasive ventilation (NIV) has been shown to improve clinical outcomes in acute and chronic hypercapnic respiratory failure. A new timed, automated, auto-adaptive non-invasive ventilatory mode (TA-mode) has been recently introduced.

Objective: To investigate the degree of respiratory muscle unloading with this new mode in comparison to assisted (S-mode) NIV in healthy individuals.

Methods: Work of breathing, pressure time product and transdiaphragmatic pressure time product were measured during unassisted breathing, assisted and TA-mode-NIV in eight healthy, awake volunteers at inspiratory pressures of 20 and expiratory pressures of 4hPa.

Results: Assisted and TA-mode-NIV reduced the work of breathing by 50 and 89.1%, pressure time product by 61.5 and 72.6% and transdiaphragmatic pressure time product by 77 and 88.7%, respectively when compared to unassisted breathing. The degree of respiratory muscle unloading was higher during TA-mode-NIV when compared to assisted non-invasive ventilation (work of breathing p<0.001, pressure time product p=0.04 and transdiaphragmatic pressure time product p=0,01).

Conclusion: TA-mode-NIV achieved significant higher levels of respiratory muscle unloading in healthy individuals when compared to assisted non-invasive ventilation.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Female
  • Humans
  • Lung Compliance
  • Male
  • Masks
  • Models, Biological
  • Pilot Projects
  • Positive-Pressure Respiration / instrumentation*
  • Respiratory Insufficiency / physiopathology*
  • Respiratory Insufficiency / rehabilitation
  • Respiratory Mechanics / physiology*
  • Respiratory Muscles / physiology*
  • Therapy, Computer-Assisted / methods
  • Treatment Outcome
  • Work of Breathing / physiology*