Framework for patient-ventilator asynchrony during long-term non-invasive ventilation

Abstract

Episodes of patient-ventilator asynchrony (PVA) occur during acute and chronic non-invasive positive pressure ventilation (NIV). In long-term NIV, description and quantification of PVA is not standardised, thus limiting assessment of its clinical impact. The present report provides a framework for a systematic analysis of polygraphic recordings of patients under NIV for the detection and classification of PVA validated by bench testing. The algorithm described uses two different time windows: rate asynchrony and intracycle asynchrony. This approach should facilitate further studies on prevalence and clinical impact of PVA in long-term NIV.

ERS International Congress 2019: highlights from Best Abstract awardees

“…Furthermore, in the poster discussion session "Hot topics in noninvasive ventilation", it became evident that reallife strategies of initial evaluation, selection of patients and follow-up are often different from those used in RCTs, indicating that there might be too little insight into barriers and facilitators of implementing evidence-based care. There were presentations about measuring patient-ventilator asynchrony (PVA), based on flow and airway pressure, in a sophisticated automatic way [20]. This strategy is attractive as it requires only minimal additional measurements and data can be post-processed to derive an asynchrony index.…”

NIV Is not Adequate for High Intensity Endurance Exercise in COPD

“…Patient-ventilator asynchrony: According to the framework proposed by the SomnoNIV group, the following asynchrony events were assessed [50][51][52][53]:…”

“…Rate asynchronies: rate asynchronies are defined as a mismatch between ventilator and patients' rates [53] and include:…”

“…Intracycle asynchronies: intracycle asynchronies were defined as a distortion of the flow and pressure curves during inspiration and/or expiration [53] and include:…”

Diagnostic accuracy of simple tools in monitoring patients with chronic hypoventilation treated with non-invasive ventilation; a prospective cross-sectional study

“…The SomnoNIV group have recently published a framework for the detection and classification of PVA with polygraphy during NIV. 263 For the detection of PVA, they recommend the use of pressure at the mask and flow from a pneumotachograph combined with abdominal and thoracic belts. Furthermore, they state that PVA should be limited to periods without leaks and upper airway obstruction: i.e.…”