Identifying and managing patient–ventilator asynchrony: An international survey

Abstract

International study conducted in 20 countries through an online survey. Participants: Physicians, respiratory therapists, nurses and physiotherapists that are currently working at the Intensive Care Unit (ICU). Main variables of interest: Univariate and multivariate logistic regression models were used to establish associations between all variables (profession, training in mechanical ventilation, type of training program, years of experience and ICU characteristics) with the ability of HCPs to correctly identify and manage 6 PVA. Results: A total of 431 HCPs answered a validated survey. The main factors associated with the proper recognition of PVA were: specific training program in mechanicalventilation (MV) (OR 2.27; 95% CI 1.14-4.52; p = 0.019), courses with more than 100 hours completed (OR 2.28; 95% CI 1.29-4.03; p = 0.005) and the number of intensive care unit (ICU) beds (OR 1.037; 95% CI 1.01-1.06; p = 0.005). The main factor that influenced PVA management was recognizing 6 PVA correctly (OR 118.98;; p < 0.001). Conclusion:Identifying and managing PVA using ventilator waveform analysis is influenced by many factors including specific training programs in MV, number of ICU beds and the recognized number of PVA.

Establishment and Application of a Patient-Ventilator Asynchrony Remote Network Platform for ICU Mechanical Ventilation: A Retrospective Study

“…However, studies have shown that the accuracy of nonexpert intensivists in identifying PVA through the ventilator waveforms at the bedside was rather poor [ 3 ]. An international research study showed that participation in specific mechanical ventilation-related training and a training time of more than 100 h can improve the accuracy of physicians in identifying PVA [ 19 ]. Nonetheless, such training was not perfect and applicable everywhere.…”

Knowledge and associated factors of healthcare professionals in detecting patient-ventilator asynchrony using waveform analysis at intensive care units of the federal public hospitals in Addis Ababa, Ethiopia, 2023

“…PVA has been associated with increased morbidity and mortality [ 9 ]. PVA can lead to several negative health consequences, including discomfort, pain, decreased quantity and quality of sleep, and prolonged ICU stay.…”

Utility of diaphragmatic ultrasonography for detection of patient‐ventilator asynchrony

“…Ventilator waveforms analysis (by trained personnel) is the usual way of observing these events, although only 19% of professionals are capable of detecting them. 3 Other more complex detection methods are esophageal manometry, automatic detection systems, specific softwares and electrodes. 2 In this sense, thoracic ultrasonography (US) has recently gained prominence in ICUs.…”