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Patient-ventilator asynchrony Tomoya OKAZAKI 1 , Yasuhiro NORISUE 2 1Emergency Medical center, Kagawa University Hospital 2Department of Emergency and Critical Care Medicine Tokyo Bay Urayasu Ichikawa Medical Center pp.525-534
Published Date 2018/7/1
DOI https://doi.org/10.11477/mf.3102200533
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Patient-ventilator asynchrony is defined as a mismatch between mechanical respiratory support and patient demands. Patient-ventilator asynchrony is categorized into trigger asynchrony (missed trigger, double trigger, auto trigger, and reversed trigger), flow asynchrony (sagging [flow starvation]), and cycling asynchrony (premature termination [premature cycling], and delayed termination [delayed cycling]). Although examination of ventilator waveforms is a non-invasive and useful technique for the evaluation of asynchrony, even expert physicians may occasionally fail to identify this phenomenon. Previous studies showed that patient-ventilator asynchrony may cause dyspnea and increase the work of breathing. In recent studies, an association between patient-ventilator asynchrony and clinical outcomes including prolonged mechanical ventilation, prolonged hospital stay, and mortality has been reported. Therefore, the characteristics of individual asynchronies should be properly recognized and promptly treated. Physical examination may play an important role in recognizing asynchrony. While adjusting ventilator settings is the primary means to resolve asynchrony, we should bear in mind that the goal is not to treat the asynchrony itself, but to protect the lung through appropriate treatment. A judicious approach to patient-ventilator asynchrony based on careful consideration of the underlying cause behind the respiratory failure and its time course is also needed.


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電子版ISSN 2186-7852 印刷版ISSN 1883-4833 メディカル・サイエンス・インターナショナル

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