Modulation and treatment of patient-ventilator dyssynchrony

Current Opinion in Critical Care

Volumn 13, Issue 1, 2007, Pages 84-89

  Kondili, Eumorfia ^a   Xirouchaki, Nektaria ^a   Georgopoulos, Dimitris ^a  

^a UNIVERSITY HOSPITAL OF HERAKLION   (Greece)

Author keywords

Assisted modes; Cycling off; Triggering; Ventilatory demands

Indexed keywords

ADULT RESPIRATORY DISTRESS SYNDROME; ARTIFICIAL VENTILATION; BREATHING PATTERN; COMPUTER PROGRAM; ELECTRIC ACTIVITY; EXPIRATORY FLOW; FLOW KINETICS; HUMAN; POSITIVE END EXPIRATORY PRESSURE; REVIEW; WAVEFORM;

CRITICAL CARE; HUMANS; POSITIVE-PRESSURE RESPIRATION; PULMONARY VENTILATION; RESPIRATION, ARTIFICIAL; RESPIRATORY INSUFFICIENCY; RESPIRATORY MECHANICS; TIDAL VOLUME; TIME FACTORS; TREATMENT OUTCOME;

EID: 33846020584     PISSN: 10705295     EISSN: 15317072     Source Type: Journal    
DOI: 10.1097/MCC.0b013e328011278d     Document Type: Review

References (25)

1. Prinianakis G, Kondili E, Georgopoulos D. Patient-ventilator interaction: an overview. Respir Care Clin N Am 2005; 11:201-224. This detailed review analyses the main pathophysiologic mechanisms of patient-ventilator interaction.
2. Thille AW, Rodriguez P, Cabello B, et al. Patient-ventilator asynchrony during assisted mechanical ventilation. Intensive Care Med 2006; Aug 1 [Epub ahead of print]. This study evaluated the incidence, the associated factors and the consequences of patient-ventilator dyssynchrony. One quarter of patients during assisted mechanical ventilation exhibited a high incidence of dyssynchrony. High ventilator assist and alkalemia have been identified as associated factors. In addition high incidence of dyssynchrony was associated with prolonged mechanical ventilation.
3. Georgopoulos D, Prinianakis G, Kondili E. Bedside waveforms interpretation as a tool to identify patient-ventilator asynchronies. Intensive Care Med 2006; 32:34-47. This comprehensive review describes the basic waveforms (flow, volume and airway pressure) during assisted mechanical ventilation and analyzes in detail how their interpretation may help the physician to recognize and modulate patient-ventilator dyssynchrony.
4. Kondili E, Georgopoulos D. New and future developments to improve patient-ventilator interaction. Respir Care Clin N Am 2005; 11:319-339. This review describes the new modes of mechanical ventilation that have been introduced aiming to improve the patient-ventilator synchrony.
5. Racca F, Squadrone V, Ranieri VM. Patient-ventilator interaction during the triggering phase. Respir Care Clin N Am 2005; 11:225-245. This review discusses in details the pathophysiology of patient-ventilator dyssynchrony during the triggering phase.
6. Tobin MJ, Jubran A, Laghi F. Patient-ventilator interaction. Am J Respir Crit Care Med 2001; 163:1059-1063.
7. Sassoon CS, Gruer SE. Characteristics of the ventilator pressure and flow-trigger variables. Intensive Care Med 1995; 21:159-168.
8. Prinianakis G, Kondili E, Georgopoulos D. Effects of the flow waveform method of triggering and cycling on patient-ventilator interaction during pressure support. Intensive Care Med 2003; 29:1950-1959.
9. Slutsky AS. Mechanical ventilation American College of Chest Physicians' Consensus Conference. Chest 1993; 104:1833-1859.
10. Sharshar T, Desmarais G, Louis B, et al. Transdiaphragmatic pressure control of airway pressure support in healthy subjects. Am J Respir Crit Care Med 2003; 168:760-769.
11. Sinderby C, Navalesi P, Beck J, et al. Neural control of mechanical ventilation in respiratory failure. Nat Med 1999; 5:1433-1436.
12. Hill LL, Pearl RG. Flow triggering, pressure triggering, and autotriggering during mechanical ventilation. Crit Care Med 2000; 28:579-581.
13. Imanaka H, Nishimura M, Takeuchi M, et al. Autotriggering caused by cardiogenic oscillation during flow-triggered mechanical ventilation. Crit Care Med 2000; 28:402-407.
14. Fabry B, Guttmann J, Eberhard L, et al. An analysis of desynchronization between the spontaneously breathing patient and ventilator during inspiratory pressure support. Chest 1995; 107:1387-1394.
15. Leung P, Jubran A, Tobin MJ. Comparison of assisted ventilator modes on triggering, patient effort, and dyspnea. Am J Respir Crit Care Med 1997; 155:1940-1948.
16. Younes M, Kun J, Webster K, Roberts D. Response of ventilator-dependent patients to delayed opening of exhalation valve. Am J Respir Crit Care Med 2002; 166:21-30.
17. Aslanian P, El Atrous S, Isabey D, et al. Effects of flow triggering on breathing effort during partial ventilatory support. Am J Respir Crit Care Med 1998; 157:135-143.
18. Giuliani R, Mascia L, Recchia F, et al. Patient-ventilator interaction during synchronized intermittent mandatory ventilation. Effects of flow triggering. Am J Respir Crit Care Med 1995; 151:1-9.
19. Sassoon CS, Del Rosario N, Fei R, et al. Influence of pressure- and flow-triggered synchronous intermittent mandatory ventilation on inspiratory muscle work. Crit Care Med 1994; 22:1933-1941.
20. Calzia E, Lindner KH, Stahl W, et al. Work of breathing, inspiratory flow response, and expiratory resistance during continuous positive airway pressure with the ventilators EVITA-2, EVITA-4 and SV 300. Intensive Care Med 1998; 24:931-938.
21. Goulet R, Hess D, Kacmarek RM. Pressure vs flow triggering during pressure support ventilation. Chest 1997; 111:1649-1653.
22. Richard JC, Carlucci A, Breton L, et al. Bench testing of pressure support ventilation with three different generations of ventilators. Intensive Care Med 2002; 28:1049-1057.
23. Tutuncu AS, Cakar N, Camci E, et al. Comparison of pressure- and flow-triggered pressure-support ventilation on weaning parameters in patients recovering from acute respiratory failure. Crit Care Med 1997; 25:756-760.
24. Mitrouska J, Xirouchaki N, Patakas D, et al. Effects of chemical feedback on respiratory motor and ventilatory output during different modes of assisted mechanical ventilation. Eur Respir J 1999; 13:873-882.
25. Bonmarchand G, Chevron V, Menard JF, et al. Effects of pressure ramp slope values on the work of breathing during pressure support ventilation in restrictive patients. Crit Care Med 1999; 27:715-722.