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  • Title: Work of breathing during SIMV with and without pressure support.
    Author: Patel DS, Rafferty GF, Lee S, Hannam S, Greenough A.
    Journal: Arch Dis Child; 2009 Jun; 94(6):434-6. PubMed ID: 19224888.
    Abstract:
    OBJECTIVE: In a randomised trial, pressure support with synchronised intermittent mandatory ventilation (SIMV) compared to SIMV alone was associated with a significant reduction in supplementary oxygen duration. The hypothesis that the addition of pressure support to SIMV compared to SIMV alone would reduce the work of breathing was examined. DESIGN: Prospective study. SETTING: Perinatal service. PATIENTS: 20 infants, with a mean gestational age of 31 weeks, being weaned from mechanical ventilation were studied. INTERVENTIONS: 1 h periods of SIMV and SIMV with pressure support at 50% of the difference between the peak inflating pressure and positive end expiratory pressures. MAIN OUTCOME MEASURES: The work of breathing was assessed by measurement of the transdiaphragmatic pressure time product (PTPdi). RESULTS: The mean PTPdi on SIMV plus pressure support was 112 cm H(2)Oxs/min, approximately 20% lower than that on SIMV alone (141 cm H(2)Oxs/min) (p<0.001). CONCLUSION: The addition of pressure support to SIMV reduces the work of breathing in infants being weaned from the ventilator.
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