Patient-ventilator dyssynchrony in the intensive care unit: A practical approach to diagnosis and management

Patient-ventilator dyssynchrony or asynchrony occurs when, for any parameter of respiration, discordance exists between the patient's spontaneous effort and the ventilator's provided support. If not recognised, it may promote oversedation, prolong the duration of mechanical ventilation, cr...

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Published inAnaesthesia and Intensive Care Vol. 49; no. 2; pp. 86 - 97
Main Authors Oto, Brandon, Annesi, Janet, Foley, Raymond J
Format Journal Article Book Review
LanguageEnglish
Published Thousand Oaks, CA SAGE Publications 01.03.2021
Sage Publications Ltd
Subjects
Diagnosis
Evaluation
Intensive care
Intensive care units
Medical diagnosis
Methodology
Patient-ventilator dyssynchrony
Respiration
Ventilation
Ventilators
bucking
vent dyssynchrony
vent synchrony
patient-ventilator synchrony
synchrony
waveform
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Summary:Patient-ventilator dyssynchrony or asynchrony occurs when, for any parameter of respiration, discordance exists between the patient's spontaneous effort and the ventilator's provided support. If not recognised, it may promote oversedation, prolong the duration of mechanical ventilation, create risk for lung injury, and generally confuse the clinical picture. Seven forms of dyssynchrony are common: (a) ineffective triggering; (b) autotriggering; (c) inadequate flow; (d) too much flow; (e) premature cycling; (f) delayed cycling; and (g) peak pressure apnoea. 'Reverse triggering' also occurs and may mimic premature cycling. Correct diagnosis of these phenomena often permits management by simple ventilator optimisation rather than by less desirable measures.
Bibliography:Anaesthesia and Intensive Care, Vol. 49, No. 2, Mar 2021, 86-97
Informit, Melbourne (Vic)
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057X20978981