Ineffective efforts during mechanical ventilation: the brain wants, the machine declines

Georgopoulos, Dimitris

doi:10.1007/s00134-012-2497-0

Cited by 9 publications

(6 citation statements)

References 25 publications

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“…92 Although a bedside evaluation of respiratory waveforms is a traditionally accepted and reliable method to identify asynchronies, [106][107][108] this technique requires specific skills and expertise. [109][110][111] It has also been suggested that an incorrect estimation of the patient's breathing frequency is one of the consequences of the difficulties in appreciating patient-ventilator asynchronies. 56,81 Furthermore, while the identification of asynchronies appears easy in extreme situations in which the patient "fights the ventilator," in other circumstances it is more difficult to detect asynchronies because most of them occur without any clinical signs.…”

Section: Visual Analysismentioning

confidence: 99%

Patient-Ventilator Asynchronies: Clinical Implications and Practical Solutions

et al. 2020

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Enterprises ePub ahead of print papers have been peer-reviewed, accepted for publication, copy edited and proofread. However, this version may differ from the final published version in the online and print editions of RESPIRATORY CARE appropriate monitoring of asynchronies is mandatory to improve the applied strategies and thus improve patient-ventilator interaction. We conducted a literature review regarding patient-ventilator interaction with a focus on the different kinds of inspiratory and expiratory asynchronies, their monitoring, clinical implications, possible prevention, and treatment. We believe that monitoring patient-ventilator interaction is mandatory in spontaneously breathing patients to understand, by using the available technologies, the type of asynchrony and consequently improve the adaptation of the ventilator to the patient's needs. Asynchronies are relatively frequent during mechanical ventilation in critically ill patients, and they are associated with poor outcomes. This review summarizes the different types of asynchronies and their mechanisms, consequences, and potential management. The development and understanding of monitoring tools are necessary to allow a better appraisal of this area, which may lead to better outcomes for patients.

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Section: Visual Analysismentioning

confidence: 99%

Patient-Ventilator Asynchronies: Clinical Implications and Practical Solutions

et al. 2020

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“…The results showed that Better Care ® was able to identify ineffective efforts with an accuracy similar to that of expert intensivists and the electrical activity of the diaphragm. These results were discussed in the accompanying editorial [11]. In 50 sedated, passively ventilated patients, Arnal et al [12] assessed the short-term safety and efficacy of IntelliVent-ASV ® , a development of adaptive support ventilation that automatically adjusts ventilation and oxygenation parameters.…”

Section: Noninvasive Ventilationmentioning

confidence: 99%

Year in review in Intensive Care Medicine 2012: III. Noninvasive ventilation, monitoring and patient–ventilator interactions, acute respiratory distress syndrome, sedation, paediatrics and miscellanea

et al. 2013

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“…The problem of ventilation synchronization has been reported before, for example, as regards incidences of ineffective triggering [8]. Studies have shown that patients with frequent ineffective patient-ventilator synchronization, i.e., ineffective efforts (IEs), have worse outcome, i.e., mortality and duration of mechanical ventilation (MV).…”

Section: Introductionmentioning

confidence: 97%

Multiparametric modeling of the ineffective efforts in assisted ventilation within an ICU

Chouvarda

Babalis

Papaioannou

et al. 2015

Med Biol Eng Comput

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In the context of assisted ventilation in ICU, it is of vital importance to keep a high synchronization between the patient's attempt to breath and the assisted ventilation event, so that the patient receives the ventilation support requested. In this work, experimental equipment is employed, which allows for unobtrusive and continuous monitoring of a multiple relevant bioparameters. These are meant to guide the medical professionals in appropriately adapting the treatment and fine-tune the ventilation. However, synchronization phenomena of different origin (neurological, mechanical, ventilation parameters) may occur, which vary among patients, and during the course of monitoring of a single patient, the timely recognition of which is challenging even for experts. The dynamics and complex causal relations among bioparameters and the ventilation synchronization are not well studied. The purpose of this work is to elaborate on a methodology toward modeling the ventilation synchronization failures based on the evolution of monitored bioparameters. Principal component analysis is employed for the transformation into a small number of features and the investigation of repeating patterns and clusters within measurements. Using these features, nonlinear prediction models based on support vector machines regression are explored, in terms of what past knowledge is required and what is the future horizon that can be predicted. The proposed model shows good correlation (over 0.74) with the actual outputs, constituting an encouraging step toward understanding of ICU ventilation dynamic phenomena.

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Ineffective efforts during mechanical ventilation: the brain wants, the machine declines

Cited by 9 publications

References 25 publications

Patient-Ventilator Asynchronies: Clinical Implications and Practical Solutions

Patient-Ventilator Asynchronies: Clinical Implications and Practical Solutions

Year in review in Intensive Care Medicine 2012: III. Noninvasive ventilation, monitoring and patient–ventilator interactions, acute respiratory distress syndrome, sedation, paediatrics and miscellanea

Multiparametric modeling of the ineffective efforts in assisted ventilation within an ICU

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