proportional assist ventilation

同

PAY

WordNet

1. give pleasant proportions to; "harmonize a building with those surrounding it"
2. the relation between things (or parts of things) with respect to their comparative quantity, magnitude, or degree; "an inordinate proportion of the book is given over to quotations"; "a dry martini has a large proportion of gin" (同)ratio
3. adjust in size relative to other things
4. the quotient obtained when the magnitude of a part is divided by the magnitude of the whole
5. magnitude or extent; "a building of vast proportions" (同)dimension
6. harmonious arrangement or relation of parts or elements within a whole (as in a design); "in all perfectly beautiful objects there is found the opposition of one part to another and a reciprocal balance"- John Ruskin (同)proportionality, balance
7. having a constant ratio
8. one of the quantities in a mathematical proportion
9. properly related in size or degree or other measurable characteristics; usually followed by `to; "the punishment ought to be proportional to the crime"; "earnings relative to production" (同)relative
10. (sports) the act of enabling another player to make a good play
11. act as an assistant in a subordinate or supportive function
12. the act of supplying fresh air and getting rid of foul air (同)airing
13. a mechanical system in a building that provides fresh air; "she was continually adjusting the ventilation" (同)ventilation system, ventilating system
14. having help; often used as a combining form (同)aided

PrepTutorEJDIC

1. 《the~》(…に対する…の)『割合』,比率《+『of』+『名』+『to』+『名』》 / 〈U〉(…との)『調和』,均衡《+『to』+『名』》 / 〈C〉部分;割り前,分け前 / 《複数形で》大きさ / 〈U〉比例 / …‘の'調和をとる;(…に)…‘を'釣り合わせる《+『名』+『to』+『名』》
2. 比例の,比例による;(…と)比例として《+『to』+『名』》 / 釣り合った,調和した;(…に)釣り合った《+『to』+『名』》
3. 〈人〉'を'『手伝う』,助力する,助ける / (…を)『手伝う』,助ける《+『in』(『with』)+『名』(do『ing』)》 / (…に)出席する,立ち会う《+『at』+『名』》
4. 換気,通風 / 換気設備,通風装置 / 世に問うこと,自由討議

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/09/15 06:49:48」(JST)

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[Wiki en表示]

Intermittent Mandatory Ventilation (IMV) refers to any mode of mechanical ventilation where a regular series of breaths are scheduled but the ventilator senses patient effort and reschedules mandatory breaths based on the calculated need of the patient. Similar to continuous mandatory ventilation in parameters set for the patients pressures and volumes but distinct in its ability to support a patient by either supporting their own effort or providing support when patient effort is not sensed. IMV is frequently paired with additional strategies to improve weaning from ventilator support or to improve cardiovascular stability in patients who may need full life support.

Synchronized intermittent mechanical ventilation (SIMV)

Synchronized Intermittent Mechanical Ventilation is a variation of IMV, in which the ventilator breaths are synchronized with patient inspiratory effort. SIMV, with and without pressure support has not been shown to have any advantages over continuous mandatory ventilation (CMV) in terms of mortality or weaning success, and has been shown to result in longer weaning times when compared to t-piece trials or gradual reductions in pressure support. Some studies have shown an increase in patient work of breathing when switched from CMV to SIMV, and others have demonstrated potential detrimental effects of SIMV on respiratory muscles and respiratory drive.

Mandatory minute ventilation (MMV)

Mandatory minute ventilation is a mode which requires the operator to determine what the appropriate minute ventilation for the patient should be, and the ventilator then monitors the patient's ability to generate this volume every 7.5 seconds. If the calculation suggests the volume target will not be met, SIMV breaths are delivered at the targeted volume to achieve the desired minute ventilation. Allows spontaneous breathing with automatic adjustments of mandatory ventilation to the meet the patient’s preset minimum minute volume requirement. If the patient maintains the minute volume settings for VT x f, no mandatory breaths are delivered. If the patient's minute volume is insufficient, mandatory delivery of the preset tidal volume will occur until the minute volume is achieved. The method for monitoring whether or not the patient is meeting the required minute ventilation (V_E) is different per ventilator brand and model, but generally there is a window of time being monitored and a smaller window being checked against that larger window (i.e., in the Dräger Evita® line of mechanical ventilators there is a moving 20-second window and every 7 seconds the current tidal volume and rate are measured against to make a decision for if a mechanical breath is needed to maintain the minute ventilation). MMV is the most optimal mode for weaning in neonatal and pediatric populations and has been shown to reduce long term complications related to mechanical ventilation.

Proportional Assist Ventilation (PAV)

Proportional assist ventilation is a mode in which the ventilator guarantees the percentage of work regardless of changes in pulmonary compliance and resistance. The ventilator varies the tidal volume and pressure based on the patients work of breathing, the amount it delivers is proportional to the percentage of assistance it is set to give.

Adaptive Support Ventilation

Adaptive Support Ventilation is a positive pressure mode of mechanical ventilation that is closed-loop controlled. In this mode, the frequency and tidal volume of breaths of a patient on the ventilator are automatically adjusted based on the patient’s requirements. The lung mechanics data are used to adjust the depth and rate of breaths to minimize the work rate of breathing. In the ASV mode, every breath is synchronized with patient effort if such an effort exists, and otherwise, full mechanical ventilation is provided to the patient.

ASV is a patented technology originally described as one of the embodiments of US Patent No. 4986268. In this invention, the control algorithm computes the optimal rate of respiration to minimize the work rate of breathing. The rationale is to make the patient's breathing pattern comfortable and natural within safe limits, and thereby stimulate spontaneous breathing and reduce the weaning time.

See also

• Modes of mechanical ventilation

References

UpToDate Contents

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• 1. 成人の急性呼吸不全における非侵襲的陽圧換気 noninvasive positive pressure ventilation in acute respiratory failure in adults
• 2. 神経筋疾患および胸壁疾患における夜間の非侵襲的換気補助の種類 types of noninvasive nocturnal ventilatory support in neuromuscular and chest wall disease
• 3. 胸壁疾患 diseases of the chest wall

English Journal

• A physiologic comparison of proportional assist ventilation with load-adjustable gain factors (PAV+) versus pressure support ventilation (PSV).

• Costa R, Spinazzola G, Cipriani F, Ferrone G, Festa O, Arcangeli A, Antonelli M, Proietti R, Conti G.SourceDepartment of Intensive Care and Anaesthesia, Catholic University of Rome, Policlinico Agostino Gemelli, Largo F.Vito 1, 00168, Rome, Italy, roberta.costa@rm.unicatt.it.
• Intensive care medicine.Intensive Care Med.2011 Sep;37(9):1494-500. Epub 2011 Jul 1.
• PURPOSE: To compare patient-ventilator interaction during PSV and PAV+ in patients that are difficult to wean.METHODS: This was a physiologic study involving 11 patients. During three consecutive trials (PSV first trial-PSV1, followed by PAV+, followed by a second PSV trial-PSV2, with the same setti
• PMID 21720909

• Emerging modes of ventilation in the intensive care unit.

• Stewart NI, Jagelman TA, Webster NR.SourceIntensive Care Unit, Aberdeen Royal Infirmary, Foresterhill Road, Aberdeen AB25 2ZN, UK.
• British journal of anaesthesia.Br J Anaesth.2011 Jul;107(1):74-82. Epub 2011 May 24.
• Potentially harmful effects of positive pressure mechanical ventilation have been recognized since its inception in the 1950s. Since then, the risk factors for and mechanisms of ventilator-induced lung injury (VILI) have been further characterized. Publication of the ARDSnet tidal volume trial in 20
• PMID 21613281

Japanese Journal

• 胸郭および腹壁伸展度測定による部分的補助換気(proportional assist ventilation)と圧支持換気(pressure support ventilation)の比較

• 西山 圭子,佐藤 敏朗,塚本 加奈子,小高 光晴,小森 万希子
• 東京女子医科大学雑誌 81(2), 89-95, 2011-04-25
• NAID 110008462585

• Proportional assist ventilation ; PAV (特集 呼吸管理プラクティカルガイド) -- (急性呼吸不全に対する換気様式の概念と適応)

• 今中 秀光
• 救急医学 34(10), 1285-1289, 2010-09
• NAID 40017320802

Related Links

• 米国呼吸療法士blog 200612

前回もいいましたが、PAV（Proportional Assist Ventilation）のProportionalとは比例 という意味です。自発呼吸を ... PAVはがんばって飲んでる時、ストローが細くなって飲み づらくなった時などにはそれに応じた強さでパックを押すということです。まさに飲む強さ ...

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★リンクテーブル★

関連記事	「proportional」「proportion」「assist」「assisted」

「proportional」

　　[★]

• adj.

• 比例した(to)、釣り合った。比例の

関

balanced、commensurable、commensurate、linear、proportion、proportionally、proportionate、proportionately、rate

　 　 　 　

「proportion」

　　[★]

• n.

• 割合、比率、比、比例。正しい関係、均衡、釣り合い、調和。分け前

• vt.

• ～を釣り合わせる

　 　 　 　 　 　 　

「assist」

　　[★]

• v.

• 補助する、援助する

関

adjunct、aid、assistance、auxiliary、help、subsidiary、support

　 　 　

「assisted」

　　[★]

• adj.

• 補助的な

関

ancillary、auxiliary