Open AccessVentilator- and interface-related factors influencing patient-ventilator asynchrony during noninvasive ventilation
Author(s) -
Hadil A Al Otair,
Ahmed S. BaHammam
Publication year - 2020
Publication title -
annals of thoracic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.639
H-Index - 33
eISSN - 1817-1737
pISSN - 1998-3557
DOI - 10.4103/atm.atm_24_19
Subject(s) - medicine , asynchrony (computer programming) , ventilation (architecture) , pressure support ventilation , work of breathing , noninvasive ventilation , respiratory system , mechanical ventilator , intensive care medicine , respiratory physiology , anesthesia , mechanical ventilation , computer science , mechanical engineering , computer network , asynchronous communication , engineering
Patient-ventilator asynchrony (PVA) is common in patients receiving noninvasive ventilation (NIV). This occurs primarily when the triggering and cycling-off of ventilatory assistance are not synchronized with the patient's inspiratory efforts and could result in increased work of breathing and niv failure. In general, five types of asynchrony can occur during NIV: ineffective inspiratory efforts, double-triggering, auto-triggering, short-ventilatory cycling, and long-ventilatory cycling. Many factors that affect PVA are mostly related to the degree of air leakage, level of pressure support, and the type and properties of the interface used. Careful monitoring and adjustment of these factors are essential to reduce PVA and improve patient comfort. In this article, we discuss the machine and interface-related factors that influence PVA during NIV and its effect on the respiratory mechanics during pressure support ventilation, which is the ventilatory mode used most commonly during NIV. For that, we critically evaluated studies that assessed ventilator- and interface-related factors that influence PVA during NIV and proposed therapeutic solutions.