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.
KEYWORD
Tracheal pressure - imposed resistive work of breathing - patient-ventilator synchrony
- ventilator responsiveness - ventilator triggering
