Pressure support ventilation (PSV) is a form of mechanical ventilation for patients that works with them when they try to breathe, instead of totally controlling the airway. It can be used with patients capable of breathing independently who are not getting quite enough air. This can be especially useful for ventilator weaning, where the eventual goal is to take the patient off the ventilator altogether. Pediatric and adult patients can be provided with pressure support ventilation, and it can also be used in operating rooms with some kinds of anesthesia.
Patients still need to wear ventilation equipment when they use pressure support ventilation. When they start to breathe in, this triggers the ventilator to increase the positive pressure in the airway, which forces air into the patient’s lungs. The patient wouldn’t be able to get enough air independently, and the ventilator ensures that sufficient gas exchange occurs. Fresh oxygen enters the blood through the lungs while the lungs exchange carbon dioxide for release. As the patient exhales, the ventilator pressure drops to allow for complete exhalation.
This patient-triggered approach provides respiratory support, rather than total respiratory control. A technician can set the machine to the specifications suitable for the patient, considering the desired amount of airflow. As the patient’s lungs improve, the level of assistance provided by the ventilator can drop, until the patient can breathe entirely independently. Such patients may need to remain on oxygen in some cases, but do not need assistance with maintaining ventilation pressure.
One benefit to this technique is that less sedation is required. Patients in intensive care sometimes need to be heavily sedated for their comfort, which is not necessarily beneficial for their long term health, and can be unsettling for family members. Pressure support ventilation creates less discomfort and distress, and can allow care providers to back down on sedation, which may promote faster healing. Patients also don’t need to stay on the ventilator as long, which reduces the risk of pneumonia and other complications.
Care providers may recommend pressure support ventilation to allow a patient to breathe as independently as possible while reducing the workload and strain on the lungs. The settings need to be carefully customized to the individual patient and can require adjustment over time. Patients who experience discomfort should alert care providers. Since a ventilator can inhibit verbal communication, they may need to touch care providers and point at the ventilator, or use paper and pen to communicate about the issue.
