S01E19 PROMIZING: PAV+ vs PSV for Ventilator Liberation

In this PRISM Rounds episode, we break down the PROMIZING randomized trial in the New England Journal of Medicine (2025) comparing proportional-assist ventilation with load-adjustable gain factors (PAV+) versus pressure-support ventilation (PSV) during weaning. We cover the physiology case for PAV+, the pragmatic reasons the primary outcome was neutral, and the most actionable takeaway for ICU teams: a consistent liberation workflow (readiness checks, SBT quality, timely extubation, and sedation strategy) often matters more than the ventilator mode itself. Education only — not medical advice. PubMed: https://pubmed.ncbi.nlm.nih.gov/40513024/Tags#CriticalCare #ICU #MechanicalVentilation #VentilatorWeaning #RespiratoryTherapy #RT #ARDS #SBT #PAVplus #PSV #NEJM #JournalClub #EvidenceBasedMedicine #FOAMed #Pulmonary #IntensiveCare #Sedation #PatientVentilatorSynchrony