Semin Respir Crit Care Med 2000; 21(3): 233-238
DOI: 10.1055/s-2000-9933
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 760-0888

Tracheal Pressure Ventilator Control

Michael J. Banner, Paul B. Blanch
  • Departments of Anesthesiology and Physiology, University of Florida, College of Medicine, and Respiratory Care Services, Shands Hospital, Gainesville, Florida
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Publication History

Publication Date:
03 March 2004 (online)

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ABSTRACT

Tracheal pressure ventilator control (TPVC) is a ventilator mode that relies on tracheal pressure at the carinal end of the endotracheal tube for triggering the ventilator ``on,'' controlling pressure, and cycling the ventilator ``off.'' TPVC automatically nullifies imposed resistive work of the breathing apparatus (endotracheal tube plus ventilator) by providing automatic and variable levels of pressure assist. TPVC improves ventilator responsiveness for a spontaneously breathing patient by providing significantly higher peak inspiratory flow rates much closer to that demanded by a patient. TPVC also provides higher assist pressures and flow rates earlier in the breath and thus better-match ventilator-supplied flow to patient-demanded flow than an equivalent level of pressure support ventilation. Matching patient demand for flow to ventilator supply of flow, early in the breath, promotes patient-ventilator synchrony and minimizes work of breathing. We recommend moving the pressure-triggering and control site to the carinal end of the endotracheal tube to provide TPVC.