Abstract

Background: A consensus about the best weaning procedure, haven't been reached. Patient–ventilator dyssynchrony can lead to considerable patient distress, prolongs mechanical ventilation and (ICU) length of stay. PAV+ delivers positive pressure ventilation in proportion to instantaneous inspiratory effort, reduces ventilator dyssynchrony and the duration of weaning from the ventilator.

Aim: Evaluate weaning outcome for COPD patients using PAV+ versus PSV, assess patient ventilator asynchrony during weaning, compare ICU outcome (hospital length of stay, ICU and hospital mortality).

Patients & Methods: 150 mechanically ventilated COPD patients were enrolled in this prospective, parallel randomized clinical trial and assigned to either PAV+ or PSV spontaneous breathing trial for weaning (after meeting specific eligibility criteria). Asynchrony was detected with bedside waveform interpretation of flow and airway pressure for 30 minutes.

Results: Weaning success was recorded in 73.3% PAV+ vs. 66.7% PSV (P= 0.373). Asynchrony events was significantly less in PAV+ vs. PSV; ineffective triggering (14.9 ± 10.3 vs. 37.6 ± 26.6, p