Adaptive Support and Pressure Support Ventilation Behavior in Response to Increased Ventilatory Demand

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Abstract
VOLUME-TARGETED pressure-regulated modes of ventilation control tidal volumes (VT) through variable levels of pressure and are referred to as dual-control modes.1 A target VT is achieved by regulating the inspiratory airway pressure (Pinsp) in a so-called negative closed loop, e.g. , if the patient’s VT is above the optimal VT, Pinsp is reduced and vice versa . A recent study found that in cases of increased respiratory demand above the set target, a reduction in Pinsp is obtained with subsequent potentially harmful increase in respiratory muscle effort.2 This is a major drawback of these modes, which may adapt adequately to changes in respiratory mechanics but adapt poorly to changes in respiratory demand.1–4

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