{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T10:29:12Z","timestamp":1791109752615,"version":"4.1.0"},"reference-count":8,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2003,1,1]],"date-time":"2003-01-01T00:00:00Z","timestamp":1041379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2003,1,1]],"date-time":"2003-01-01T00:00:00Z","timestamp":1041379200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respiration"],"published-print":{"date-parts":[[2003]]},"abstract":"<i>Background:<\/i> Proportional assist ventilation (PAV) has been shown to maintain better patient-ventilator synchrony than pressure support ventilation (PSV); however, its clinical advantage regarding invasive ventilation of COPD patients has not been clarified. <i>Objectives:<\/i> To compare the effect of PAV and PSV on respiratory parameters of hypercapnic COPD patients with acute respiratory failure (ARF). <i>Methods:<\/i> Nine intubated hypercapnic COPD patients were placed on the PAV or PSV mode in random sequence. For each mode, four levels (L<sub>1<\/sub>\u2013L<sub>4<\/sub>) of support were applied. At each level, blood gases, flow, tidal volume (V<sub>T<\/sub>), airway pressure (Paw), esophageal pressure (Pes) (n = 7), patient respiratory rate (fp), ventilator rate (fv), missing efforts (ME = fp \u2013 fv) were measured. <i>Results:<\/i> We found increases in ME with increasing levels of PSV but not with PAV. PO<sub>2 <\/sub>and V<sub>T<\/sub> increased whereas PCO<sub>2 <\/sub>decreased significantly with increasing levels of PSV (p < 0.05). With PAV, PCO<sub>2 <\/sub>decreased and V<sub>T <\/sub>increased significantly only at L<sub>4<\/sub> whereas PO<sub>2 <\/sub>increased from L<sub>1<\/sub> to L<sub>4<\/sub>. Runaways were observed at L<sub>3 <\/sub>and L<sub>4 <\/sub>of PAV. The pressure-time product (PTP) was determined for effective and missing breaths. The mean total PTP per minute (of effective plus missing breaths) was 160 \u00b1 57 cm H<sub>2<\/sub>O\/s\u00b7min in PSV and 194 \u00b1 60 cm H<sub>2<\/sub>O\/s\u00b7min in PAV. <i>Conclusion:<\/i> We conclude that in COPD patients with hypercapnic ARF, with increasing support, PSV causes the appearance of ME whereas PAV develops runaway phenomena, due to the different patient-ventilator interaction; however, these do not limit the improvement of blood gases with the application of both methods.<\/jats:p>","DOI":"10.1159\/000072897","type":"journal-article","created":{"date-parts":[[2003,9,26]],"date-time":"2003-09-26T10:26:33Z","timestamp":1064571993000},"page":"355-361","source":"Crossref","is-referenced-by-count":36,"title":["Effect of Different Levels of Pressure Support and Proportional Assist Ventilation on Breathing Pattern, Work of Breathing and Gas Exchange in Mechanically Ventilated Hypercapnic COPD Patients with Acute Respiratory Failure"],"prefix":"10.1159","volume":"70","author":[{"given":"F.","family":"Passam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Hoing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Prinianakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Siafakas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Milic-Emili","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Georgopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2003,9,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199701000-00012"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s001340051001"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s001340050954"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00.16349100"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200006000-00016"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200202000-00010"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200203-214OC"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.96.09102151"}],"container-title":["Respiration"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/72897","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/72897","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T03:45:01Z","timestamp":1745466301000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000072897"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003]]},"references-count":8,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2003,8,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000072897","archive":["Portico"],"relation":{},"ISSN":["0025-7931","1423-0356"],"issn-type":[{"value":"0025-7931","type":"print"},{"value":"1423-0356","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003]]}}}