الفهرس 
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Abstract
Although mechanical ventilation saves lives, it is also responsible for many deaths. Accordingly, it is critical to get patients off the ventilator at the earliest possible time. Pressure support ventilation (PSV) is a pressure limited, flow-cycled mode of assisted ventilation, in which each breath is supported by a constant level of pressure at the airway (Paw), so that the tidal volume and inspiratory flow are more adaptable to the patients own ventilatory demand. The aim of our study was to evaluate the efficacy and safety of pressure support mode as an initiating mode of ventilation for type ii respiratory failure patients. This prospective single blind randomized interventional control study was conducted at chest department, ICU unit, Mansoura University Hospital and consisted of 60 patients who were mechanically ventilated with hypercapnic arterial blood gases. We studied 60 patients .All were intubated and mechanically ventilated with hypercapnic arterial blood gases .The mean age of 60 studied patients was 63.45±10.16. Forty patients were male and twenty patients were female. Twenty two patients 22 were nonsmoker, twenty patients 20 were current smoker and eighteen patients 18 were ex-smoker. Our patients divided into groups: group A 30 patients their ventilation were initiated with pressure support mode and group B 30 patients their ventilation were initiated with controlled mode. Between both groups there was no significant statistical difference as regard age, gender ,smoking and severity scoring index ; charlson co morbidity index and APACHE II score with( p value <0.05 ) There were no significant statistical differences between both groups as regard clinical diagnosis, laboratory data and arterial blood gases readings. We found that in group A 18 patients were successfully extubated when pressure support mode was used as mode of initiation. Remain twelve patients was considered as mode failure as three patients were re intubated within 48 hours after extubation and nine patients ,we were obliged to transfer them to controlled modes and continue as group B. As regard group B ventilation of thirty patients were initiated using controlled modes either volume control, pressure control or pressure regulating volume control. But nine patients from group A their initial ventilation failed with pressure support mode and continue as group B with controlled modes. Thirty four patients were successfully extubated, 5 patients considered mode failure: two patients were re intubated within 48 hours after extubation and three patient died. Conclusions: In spite of pressure support mode is less effective than controlled mode but still we can ventilate type II RF patients using it with reasonable efficacy based on shorter duration of ventilation and less consumption of sedation. PSV is safe mode as it has less incidence of complication compared to controlled modes.