الفهرس | Only 14 pages are availabe for public view |
Abstract In critically ill patients, mechanical ventilation (MV) aims to improve oxygenation and decrease the work of breathing and load on the respiratory muscles to support patients until their condition improves. (1) Optimal patient-ventilator interaction can help avoid excessive sedation, anxiety, discomfort, episodes of fighting on the ventilator, diaphragmatic dysfunction and atrophy due to disuse, potential cognitive alterations, prolonged mechanical ventilation, and additional lung or respiratory muscle injury. (2) Research has shown that patients ventilated for 24 hours who can trigger the ventilator have a high incidence of asynchrony during assisted mechanical ventilation. (3) Asynchrony is common throughout MV, (4) occurs in all MV modes, and might be associated with a bad outcome, especially when they occur in clusters. (5) Patient-ventilator asynchrony (PVA) exists when the phases of breath delivered by the ventilator do not match those of the patient. (6) To meet the patient’s demands, the ventilator’s inspiratory time and gas delivery must match the patient’s neural inspiratory time. (7) Asynchronies occur with minimal differences between day and night, and the most prevalent asynchrony overall and in every MV mode is ineffective inspiratory efforts, followed by double triggering. (8) When the entire period of MV is taken into account, asynchronies are slightly more frequent in pressure support ventilation (PSV) than in volume control-continuous mandatory ventilation or pressure control-continuous mandatory ventilation. (9) |