Patient-Ventilator Asynchrony

A time mismatch between patient's inspiratory effort and MECHANICAL VENTILATOR's inspiratory time.

Also Known As:

Asynchrony, Patient-Ventilator; Dyssynchrony, Patient-Ventilator; Patient Ventilator Asynchronies; Patient Ventilator Asynchrony; Patient Ventilator Dyssynchronies; Patient Ventilator Dyssynchrony; Patient-Ventilator Asynchronies; Patient-Ventilator Dyssynchronies; Patient-Ventilator Dyssynchrony

Networked: 186 relevant articles (9 outcomes, 14 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Respiratory Distress Syndrome (Acute Respiratory Distress Syndrome)
2.	Chronic Obstructive Pulmonary Disease (COPD)
3.	Central Sleep Apnea (Central Sleep Apnea Syndrome)
4.	Critical Illness (Critically Ill)
5.	Hypoxia (Hypoxemia)

Experts

1.	Piquilloud, Lise: 7 articles (01/2021 - 12/2010)
2.	Brochard, Laurent: 7 articles (09/2016 - 10/2006)
3.	Jolliet, Philippe: 7 articles (11/2013 - 05/2009)
4.	Magrans, Rudys: 6 articles (09/2021 - 04/2018)
5.	Navalesi, Paolo: 6 articles (06/2019 - 11/2008)
6.	Blanch, Lluis: 6 articles (01/2019 - 02/2007)
7.	de Haro, Candelaria: 5 articles (09/2021 - 04/2018)
8.	Jaber, Samir: 5 articles (01/2021 - 01/2013)
9.	Vignaux, Laurence: 5 articles (10/2013 - 05/2009)
10.	Pelosi, Paolo: 4 articles (01/2022 - 01/2021)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Patient-Ventilator Asynchrony:

1.	Hypnotics and Sedatives (Sedatives)IBA 05/01/2006 - "Study duration was 3 days, with a brief daily "wake-up." We recorded the number of hours/day that patients were "off-target" with their Ramsay Sedation Scores, the number of dose titrations per day, the incidence of patient-ventilator asynchrony, and the time required to achieve adequate sedation as measures of sedative efficacy. " 12/01/2015 - "The secondary outcomes were all-cause in-hospital mortality, dosages of analgesics and sedatives, incidence of patient-ventilator asynchrony, and duration of mechanical ventilation and hospital stay. " 12/01/2015 - "In patients with moderate ARDS, SIMV + PS can safely and effectively improve oxygenation, but does not decrease mortality, incidence of delirium and patient-ventilator asynchrony, dosages of analgesics and sedatives, and duration of mechanical ventilation and hospital stay." 12/01/2015 - "However, there were no significant differences in incidence of delirium and mortality, dosages of analgesics and sedatives, incidence of patient-ventilator asynchrony, duration of mechanical ventilation and hospital stay (P>0.05). " 04/01/2011 - "Critically ill patients are prescribed sedatives and analgesics to decrease pain and anxiety, improve patient-ventilator dyssynchrony and ensure patient safety. "
2.	Dexmedetomidine FDA Link 07/02/2016 - "The aim of this study was to compare the incidence of patient-ventilator dyssynchronies during sedation with dexmedetomidine or propofol. "
3.	Propofol (Diprivan)FDA LinkGeneric 07/02/2016 - "The aim of this study was to compare the incidence of patient-ventilator dyssynchronies during sedation with dexmedetomidine or propofol. "
4.	Neuromuscular Blocking AgentsIBA 01/01/2021 - "However, patients with SARS-CoV-2 pneumonia tend to have an intense respiratory drive resulting in patient-ventilator asynchrony when neuromuscular blocking agents are discontinued. " 12/01/2020 - "Neuromuscular blocking agents (NMBAs) inhibit patient-initiated active breath and the risk of high tidal volumes and consequent high transpulmonary pressure swings, and minimize patient/ ventilator asynchrony in acute respiratory distress syndrome (ARDS). " 01/01/2020 - "Neuromuscular blocking agents are regularly used in the intensive care unit (ICU) to facilitate mechanical ventilation in patients with acute respiratory distress syndrome and patient-ventilator dyssynchronies. " 01/01/2021 - "The Delphi process yielded strong suggestions for use of systemic corticosteroids for critical COVID-19; awake self-proning to improve oxygenation and high flow nasal oxygen to potentially reduce tracheal intubation; non-invasive ventilation for patients with mixed hypoxemic-hypercapnic respiratory failure; tracheal intubation for poor mentation, hemodynamic instability or severe hypoxemia; closed suction systems; lung protective ventilation; prone ventilation (for 16-24 h per day) to improve oxygenation; neuromuscular blocking agents for patient-ventilator dyssynchrony; avoiding delay in extubation for the risk of reintubation; and similar timing of tracheostomy as in non-COVID-19 patients. "
5.	sulfated polyvinyl alcoholIBA 10/27/2023 - "Furthermore, 78% of the clinicians reviewed data for the assessment of patient ventilator asynchrony (PVA), although the confidence reported in identifying certain PVAs was reported as unconfident or extremely unconfident. " 01/01/2020 - "Background and objectives: Patient-ventilator asynchronies (PVAs) are common in mechanically ventilated patients. " 01/01/2017 - "We aim to provide more insight into NIV titration by comparing the effects of a spontaneous (S) and spontaneous-timed (ST) modes on gas exchange, sleep architecture and patient-ventilator asynchronies (PVAs). " 11/01/2017 - "Patient-ventilator asynchronies (PVAs) occur when the timing of the ventilator cycle is not simultaneous with the timing of the patient respiratory cycle. "
6.	Oxygen (Dioxygen)IBA 08/01/2008 - "Patient-ventilator asynchrony and discomfort can occur if the physician or respiratory therapist fails to adequately set NIV to respond to the patient's ventilatory demand, so clinicians need to fully understood the ventilator's technical peculiarities (eg, efficiency of trigger and cycle systems, speed of pressurization, air-leak compensation, CO(2) rebreathing, reliability of fraction of inspired oxygen reading, monitoring accuracy). " 01/01/2017 - "We also highlight recent data on patient-ventilator dyssynchrony, humidified high-flow oxygen through nasal cannula, extracorporeal life support, and the weaning phase. " 01/01/2021 - "The Delphi process yielded strong suggestions for use of systemic corticosteroids for critical COVID-19; awake self-proning to improve oxygenation and high flow nasal oxygen to potentially reduce tracheal intubation; non-invasive ventilation for patients with mixed hypoxemic-hypercapnic respiratory failure; tracheal intubation for poor mentation, hemodynamic instability or severe hypoxemia; closed suction systems; lung protective ventilation; prone ventilation (for 16-24 h per day) to improve oxygenation; neuromuscular blocking agents for patient-ventilator dyssynchrony; avoiding delay in extubation for the risk of reintubation; and similar timing of tracheostomy as in non-COVID-19 patients. "
7.	Midazolam (Versed)FDA LinkGeneric 06/01/2020 - "Severe patient-ventilator asynchrony was related to the level of sedation (ineffective trigger: p = 0.020; insufficient flow: p = 0.016; premature cycling: p = 0.023) and the use of midazolam (p = 0.020). " 05/01/2006 - "Fewer episodes per day of patient-ventilator asynchrony were noted in the co-sedation group compared with midazolam-only (0.4 +/- 0.1 and 1.0 +/- 0.2, respectively, p < .05). "
8.	Analgesics (Analgesic Drugs)IBA 12/01/2015 - "The secondary outcomes were all-cause in-hospital mortality, dosages of analgesics and sedatives, incidence of patient-ventilator asynchrony, and duration of mechanical ventilation and hospital stay. " 12/01/2015 - "In patients with moderate ARDS, SIMV + PS can safely and effectively improve oxygenation, but does not decrease mortality, incidence of delirium and patient-ventilator asynchrony, dosages of analgesics and sedatives, and duration of mechanical ventilation and hospital stay." 12/01/2015 - "However, there were no significant differences in incidence of delirium and mortality, dosages of analgesics and sedatives, incidence of patient-ventilator asynchrony, duration of mechanical ventilation and hospital stay (P>0.05). " 04/01/2011 - "Critically ill patients are prescribed sedatives and analgesics to decrease pain and anxiety, improve patient-ventilator dyssynchrony and ensure patient safety. "
9.	Therapeutic UsesIBA 04/01/2012 - "Despite the impediments to efficient aerosol delivery because of continuous gas flow, high inspiratory flow rates, air leaks, circuit humidity, and patient-ventilator asynchrony, significant therapeutic effects are achieved after inhaled bronchodilator administration to patients with asthma and chronic obstructive pulmonary disease. "
10.	Narcotics (Narcotic Analgesics)IBA 09/01/2023 - "There is increasing awareness of patient-ventilator dyssynchrony (PVD), a mismatch between patient respiratory effort and assistance provided by the ventilator, as a risk factor for infection, narcotic exposure, lung injury, and adverse neurocognitive effects. "

Therapies and Procedures

1.	Mechanical Ventilators (Ventilator) 10/01/2017 - "Efficacy of ventilator waveform observation for detection of patient-ventilator asynchrony during NIV: a multicentre study." 01/01/2023 - "We showed that the display of the Pmus waveform improved the ability of healthcare professionals to recognize patient-ventilator asynchronies by visual inspection of ventilator tracings. " 11/01/2011 - "Efficacy of ventilator waveforms observation in detecting patient-ventilator asynchrony." 11/01/2008 - "Compared to PSV, NAVA averted the risk of over-assistance, avoided patient-ventilator asynchrony, and improved patient-ventilator interaction." 01/01/2023 - "Impact on the ability of healthcare professionals to correctly identify patient-ventilator asynchronies of the simultaneous visualization of estimated muscle pressure curves on the ventilator display: a randomized study (Pmus study)."
2.	Interactive Ventilatory Support 08/08/2015 - "The main objective of the present study was to demonstrate a decrease in the total number of patient-ventilator asynchronies in invasively ventilated patients for whom difficulty in weaning is expected by comparing neurally adjusted ventilatory assist (NAVA) and pressure support ventilation (PSV) ventilatory modes. " 01/01/2021 - "Neurally adjusted ventilatory assist (NAVA), a mode of partial ventilatory assist that reduces patient-ventilator asynchrony, may be an alternative for weaning. " 12/23/2019 - "Although neurally adjusted ventilatory assist (NAVA) could be associated with lower patient-ventilator asynchrony compared with conventional ventilation, its effects on diaphragmatic dysfunction have not yet been well elucidated. " 01/01/2018 - "Patient ventilator asynchrony, as quantified by the NeuroSync index, was lower during neurally adjusted ventilatory assist (18.3% ± 6.3%) compared with SIMVBL (46.5% ±11.7%; p < 0.05) and SIMVADJ (45.8% ± 9.4%; p < 0.05). " 05/01/2017 - "Proportional assist ventilation (PAV) offers inspiratory assistance proportional to patient effort, minimizing patient-ventilator asynchrony. "
3.	Artificial Respiration (Mechanical Ventilation) 11/01/2016 - "Improved recognition of patient-ventilator asynchrony may reduce duration of mechanical ventilation. " 01/01/2019 - "EPISYNC study: predictors of patient-ventilator asynchrony in a prospective cohort of patients under invasive mechanical ventilation - study protocol." 04/01/2018 - "Most reviewed trials have shown that mechanical ventilation is probably not the main factor causing sleep disturbances, but an appropriate ventilation strategy can significantly help to improve its quality by reducing the frequency of the patient-ventilator asynchrony. " 11/01/2023 - "Patient-ventilator asynchrony is often observed during mechanical ventilation and is associated with higher mortality. " 10/24/2023 - "Patient-ventilator asynchrony is common during mechanical ventilation (MV) in intensive care unit (ICU), leading to worse MV care outcome. "
4.	Noninvasive Ventilation 01/01/2022 - "Patient-ventilator asynchrony is a major issue during non-invasive ventilation and may lead to discomfort and treatment failure. " 01/01/2022 - "Monitoring the patient-ventilator asynchrony during non-invasive ventilation." 07/01/2021 - "Pediatric noninvasive ventilation (NIV) is used commonly in the acute care setting and is associated with high incidence of patient ventilator asynchrony. " 10/01/2020 - "Patient-ventilator asynchrony is associated with intolerance to noninvasive ventilation (NIV) and worsened outcomes. " 09/01/2020 - "Double-triggering is a well-recognized form of patient-ventilator asynchrony in noninvasive ventilation (NIV). "
5.	Critical Care (Surgical Intensive Care) 11/01/2017 - "Bayesian joint modeling of bivariate longitudinal and competing risks data: An application to study patient-ventilator asynchronies in critical care patients." 01/01/2021 - "Can visual inspection of the electrical activity of the diaphragm improve the detection of patient-ventilator asynchronies by pediatric critical care physicians?" 07/01/2012 - "To assess the effect of no sedation protocol compared with daily interruption of sedation on patient-ventilator asynchrony in surgical intensive care patients. " 11/10/2020 - "Patient-ventilator asynchrony was not associated with prolonged duration of mechanical ventilation or paediatric intensive care stay. " 09/01/2020 - "Patient-Ventilator Asynchrony in Critical Care Settings: National Outcomes of Ventilator Waveform Analysis."