PPS ventilation

PPS ventilation ( Proportional Pressure Support - proportional pressure-supported ventilation) is a modern form of ventilation in intensive care medicine .

In comparison to the ASB , there is no static pressure support for inspiration (inhalation), but variable pressure and volume-dependent air application . With PPS, the patient breathes spontaneously . So he controls the breathing rate according to his own senses and the ventilator supports inhalation through a flow , i.e. an air flow that is available in the ventilation system, as well as through volume support , i.e. a certain amount of air that is added with each breath. The aim is to make breathing easier. It is assumed that the patient is too weak to provide himself with sufficient breathing and that the need is covered by the mechanical addition.

The preset trigger limit must be overcome for inspiration, but there is a high supply of air due to the flow, so that inhalation is even easier than with ASB. The volume support then adds a preset amount of air to the breath .

Proportional pressure-assisted ventilation (PPS) emerged in 1997 from a process known as Proportional Assist Ventilation (PAV).

Necessary control parameters for monitoring

• Breathing rate (respiration)
• Minute volume and spontaneous minute volume (the two do not have to be identical , because with BIPAP ventilation it is possible that the respirator, i.e. the ventilator, performs breathing rates and the patient does not perform his own breathing)
• Tidal volume inspiratory (when breathing in) and expiratory (when breathing out), in the technical term we speak of tidal volume
• Blood gases and oxygen saturation
• Stress parameters such as blood pressure , pulse and sweating

It is therefore urgently indicated that a patient who needs breathing assistance is cared for in an intensive care unit in the hospital , where all parameters are monitored and ventilators are available that can support people in their breathing work. As part of the emergency medicine ASB plays a subordinate role.

Setting parameters on the ventilator

• Trigger threshold (is usually set between 2 and 5 mbar )
• Flow-Assist (i.e. the air flow in the system, e.g. Dräger recommends starting with a Flow-Assist of 7 mbar and adapting it to the development of the ventilation situation)
• Volume-Assist (i.e. the pressure with which the additional volume is administered; an initial setting of 7 is also recommended here)
• PEEP pressure (varies according to the needs of the patient; is set as low as possible; ventilation is often started with a PEEP of 5 mbar and then stopped later, the PEEP is rarely below, occasionally - depending on the clinical picture - also significantly above)

Adjustments are made by a doctor or an experienced nurse, the liability rests with the doctor. If the patient's situation changes (e.g. due to pulmonary exhaustion), the ventilation parameters must be adjusted.

Contraindication

The absolute contraindication is the patient's lack of spontaneous breathing. If the patient does not have his own respiratory drive (due to illness or medication), this form of ventilation cannot be used.

The relative contraindication is too deep sedation and a lack of patient compliance .

Individual evidence

1. ^ M. Younes: Proportional assist ventilation (PAV). In: MJ Tobin (Ed.): Principles and practice of mechanical Ventilation. Pp. 349-369.
2. ↑ Ernst Bahns: It all started with the Pulmotor. The history of mechanical ventilation. Drägerwerk, Lübeck 2014, p. 76 f. ( The regulation of the pressure support by the patient ).

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !