Skip to main content
Erschienen in: Critical Care 4/2011

01.08.2011 | Commentary

On the imperfect synchrony between patient and ventilator

verfasst von: Paolo Navalesi

Erschienen in: Critical Care | Ausgabe 4/2011

Einloggen, um Zugang zu erhalten

Abstract

Because patient-ventilator asynchrony (PVA) is recognized as a major clinical problem for patients undergoing ventilatory assistance, automatic methods of PVA detection have been proposed in recent years. A novel approach is airflow spectral analysis, which, when related to visual inspection of airway pressure and flow waveforms, has been shown to reach a sensitivity and specificity of greater than 80% in detecting an asynchrony index of greater than 10%. The availability of automatic non-invasive methods of PVA detection at the bedside would likely be of benefit in intensive care unit practice, but they may be limited by shortcomings, so clear proof of their effectiveness is needed.
Literatur
1.
Zurück zum Zitat Gutierrez G, Ballarino GJ, Turkan H, Abril J, De La Cruz L, Edsall C, George B, Gutierrez S, Jha V, Ahari J: Automatic detection of patient-ventilator asynchrony by spectral analysis of airway flow. Crit Care. 2011, 15: R167-10.1186/cc10309.PubMedPubMedCentralCrossRef Gutierrez G, Ballarino GJ, Turkan H, Abril J, De La Cruz L, Edsall C, George B, Gutierrez S, Jha V, Ahari J: Automatic detection of patient-ventilator asynchrony by spectral analysis of airway flow. Crit Care. 2011, 15: R167-10.1186/cc10309.PubMedPubMedCentralCrossRef
2.
Zurück zum Zitat Cuvelier A, Achour L, Rabarimanantsoa H, Letellier C, Muir JF, Fauroux B: A noninvasive method to identify ineffective triggering in patients with noninvasive pressure support ventilation. Respiration. 2010, 80: 198-206. 10.1159/000264606.PubMedCrossRef Cuvelier A, Achour L, Rabarimanantsoa H, Letellier C, Muir JF, Fauroux B: A noninvasive method to identify ineffective triggering in patients with noninvasive pressure support ventilation. Respiration. 2010, 80: 198-206. 10.1159/000264606.PubMedCrossRef
3.
Zurück zum Zitat Chen CW, Lin WC, Hsu CH, Cheng KS, Lo CS: Detecting ineffective triggering in the expiratory phase in mechanically ventilated patients based on airway flow and pressure deflection: feasibility of using a computer algorithm. Crit Care Med. 2008, 36: 455-461. 10.1097/01.CCM.0000299734.34469.D9.PubMedCrossRef Chen CW, Lin WC, Hsu CH, Cheng KS, Lo CS: Detecting ineffective triggering in the expiratory phase in mechanically ventilated patients based on airway flow and pressure deflection: feasibility of using a computer algorithm. Crit Care Med. 2008, 36: 455-461. 10.1097/01.CCM.0000299734.34469.D9.PubMedCrossRef
4.
Zurück zum Zitat Mulqueeny Q, Ceriana P, Carlucci A, Fanfulla F, Delmastro M, Nava S: Automatic detection of ineffective triggering and double triggering during mechanical ventilation. Intensive Care Med. 2007, 33: 2014-2018. 10.1007/s00134-007-0767-z.PubMedCrossRef Mulqueeny Q, Ceriana P, Carlucci A, Fanfulla F, Delmastro M, Nava S: Automatic detection of ineffective triggering and double triggering during mechanical ventilation. Intensive Care Med. 2007, 33: 2014-2018. 10.1007/s00134-007-0767-z.PubMedCrossRef
5.
Zurück zum Zitat Younes M, Brochard L, Grasso S, Kun J, Mancebo J, Ranieri M, Richard JC, Younes H: A method for monitoring and improving patient: ventilator interaction. Intensive Care Med. 2007, 33: 1337-1346. 10.1007/s00134-007-0681-4.PubMedCrossRef Younes M, Brochard L, Grasso S, Kun J, Mancebo J, Ranieri M, Richard JC, Younes H: A method for monitoring and improving patient: ventilator interaction. Intensive Care Med. 2007, 33: 1337-1346. 10.1007/s00134-007-0681-4.PubMedCrossRef
6.
Zurück zum Zitat Chao DC, Scheinhorn DJ, Stearn-Hassenpflug M: Patient-ventilator trigger asynchrony in prolonged mechanical ventilation. Chest. 1997, 112: 1592-1599. 10.1378/chest.112.6.1592.PubMedCrossRef Chao DC, Scheinhorn DJ, Stearn-Hassenpflug M: Patient-ventilator trigger asynchrony in prolonged mechanical ventilation. Chest. 1997, 112: 1592-1599. 10.1378/chest.112.6.1592.PubMedCrossRef
7.
Zurück zum Zitat Thille AW, Rodriguez P, Cabello B, Lellouche F, Brochard L: Patient-ventilator asynchrony during assisted mechanical ventilation. Intensive Care Med. 2006, 32: 1515-1522. 10.1007/s00134-006-0301-8.PubMedCrossRef Thille AW, Rodriguez P, Cabello B, Lellouche F, Brochard L: Patient-ventilator asynchrony during assisted mechanical ventilation. Intensive Care Med. 2006, 32: 1515-1522. 10.1007/s00134-006-0301-8.PubMedCrossRef
8.
Zurück zum Zitat de Wit M, Miller KB, Green DA, Ostman HE, Gennings C, Epstein SK: Ineffective triggering predicts increased duration of mechanical ventilation. Crit Care Med. 2009, 37: 2740-2745. 10.1097/CCM.0b013e3181a98a05.PubMedCrossRef de Wit M, Miller KB, Green DA, Ostman HE, Gennings C, Epstein SK: Ineffective triggering predicts increased duration of mechanical ventilation. Crit Care Med. 2009, 37: 2740-2745. 10.1097/CCM.0b013e3181a98a05.PubMedCrossRef
9.
Zurück zum Zitat Colombo D, Cammarota G, Alemani M, Carenzo L, Barra F, Vaschetto R, Slutsky AS, Della Corte F, Navalesi P: Efficacy of ventilator waveforms observation in detecting patient-ventilator asynchrony. Crit Care Med. 2011 Colombo D, Cammarota G, Alemani M, Carenzo L, Barra F, Vaschetto R, Slutsky AS, Della Corte F, Navalesi P: Efficacy of ventilator waveforms observation in detecting patient-ventilator asynchrony. Crit Care Med. 2011
10.
Zurück zum Zitat Younes M: Proportional assist ventilation, a new approach to ventilatory support. Theory. Am Rev Respir Dis. 1992, 145: 114-120.PubMedCrossRef Younes M: Proportional assist ventilation, a new approach to ventilatory support. Theory. Am Rev Respir Dis. 1992, 145: 114-120.PubMedCrossRef
11.
Zurück zum Zitat Sinderby C, Navalesi P, Beck J, Skrobik Y, Comtois N, Friberg S, Gottfried SB, Lindstrom L: Neural control of mechanical ventilation in respiratory failure. Nat Med. 1999, 5: 1433-1436. 10.1038/71012.PubMedCrossRef Sinderby C, Navalesi P, Beck J, Skrobik Y, Comtois N, Friberg S, Gottfried SB, Lindstrom L: Neural control of mechanical ventilation in respiratory failure. Nat Med. 1999, 5: 1433-1436. 10.1038/71012.PubMedCrossRef
12.
Zurück zum Zitat Navalesi P, Costa R: New modes of mechanical ventilation: proportional assist ventilation, neurally adjusted ventilatory assist, and fractal ventilation. Curr Opin Crit Care. 2003, 9: 51-58. 10.1097/00075198-200302000-00010.PubMedCrossRef Navalesi P, Costa R: New modes of mechanical ventilation: proportional assist ventilation, neurally adjusted ventilatory assist, and fractal ventilation. Curr Opin Crit Care. 2003, 9: 51-58. 10.1097/00075198-200302000-00010.PubMedCrossRef
13.
Zurück zum Zitat Vignaux L, Vargas F, Roeseler J, Tassaux D, Thille AW, Kossowsky MP, Brochard L, Jolliet P: Patient-ventilator asynchrony during non-invasive ventilation for acute respiratory failure: a multicenter study. Intensive Care Med. 2009, 35: 840-846. 10.1007/s00134-009-1416-5.PubMedCrossRef Vignaux L, Vargas F, Roeseler J, Tassaux D, Thille AW, Kossowsky MP, Brochard L, Jolliet P: Patient-ventilator asynchrony during non-invasive ventilation for acute respiratory failure: a multicenter study. Intensive Care Med. 2009, 35: 840-846. 10.1007/s00134-009-1416-5.PubMedCrossRef
14.
Zurück zum Zitat Navalesi P, Costa R, Ceriana P, Carlucci A, Prinianakis G, Antonelli M, Conti G, Nava S: Non-invasive ventilation in chronic obstructive pulmonary disease patients: helmet versus facial mask. Intensive Care Med. 2007, 33: 74-81. 10.1007/s00134-006-0391-3.PubMedCrossRef Navalesi P, Costa R, Ceriana P, Carlucci A, Prinianakis G, Antonelli M, Conti G, Nava S: Non-invasive ventilation in chronic obstructive pulmonary disease patients: helmet versus facial mask. Intensive Care Med. 2007, 33: 74-81. 10.1007/s00134-006-0391-3.PubMedCrossRef
15.
Zurück zum Zitat Fink BR: The stimulant effect of wakefulness on respiration: clinical aspects. Br J Anaesth. 1961, 33: 97-101. 10.1093/bja/33.2.97.PubMedCrossRef Fink BR: The stimulant effect of wakefulness on respiration: clinical aspects. Br J Anaesth. 1961, 33: 97-101. 10.1093/bja/33.2.97.PubMedCrossRef
Metadaten
Titel
On the imperfect synchrony between patient and ventilator
verfasst von
Paolo Navalesi
Publikationsdatum
01.08.2011
Verlag
BioMed Central
Erschienen in
Critical Care / Ausgabe 4/2011
Elektronische ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc10300

Weitere Artikel der Ausgabe 4/2011

Critical Care 4/2011 Zur Ausgabe

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.