Respiratory Monitoring During Mechanical Ventilation: The Present and the Future

Abstract

The increased application of mechanical ventilation, the recognition of its harms and the interest in individualization raised the need for an effective monitoring. An increasing number of monitoring tools and modalities were introduced over the past 2 decades with growing insight into asynchrony, lung and chest wall mechanics, respiratory effort and drive. They should be used in a complementary rather than a standalone way. A sound strategy can guide a reduction in adverse effects like ventilator-induced lung injury, ventilator-induced diaphragm dysfunction, patient-ventilator asynchrony and helps early weaning from the ventilator. However, the diversity, complexity, lack of expertise, and associated cost make formulating the appropriate monitoring strategy a challenge for clinicians. Most often, a big amount of data is fed to the clinicians making interpretation difficult. Therefore, it is fundamental for intensivists to be aware of the principle, advantages, and limits of each tool. This analytic review includes a simplified narrative of the commonly used basic and advanced respiratory monitors along with their limits and future prospective.

Application of a cloud platform that identifies patient-ventilator asynchrony and enables continuous monitoring of mechanical ventilation in intensive care unit

“…Moreover, the incidence of PVA is often underestimated due to inadequate monitoring or the relative inexperience of physicians [ 12 ]. Accurate and timely identification of PVA requires improved monitoring techniques and enhanced expertise among healthcare teams [ 13 ].…”

“…Various monitoring modalities have been proposed for mechanical ventilation [ 13 ]. Compared to other complex and invasive methods such as esophageal balloon, ventilator graphics are crucial for monitoring PVA due to their non-invasive, user-friendly, and practical nature.…”

Critical Care Nursing in a Resource-Constrained Setting: A Qualitative Study of Critical Care Nurses’ Experiences Caring for Patients on Mechanical Ventilation

“…Managing a patient on mechanical ventilation is a complex and dynamic task that requires extensive knowledge and skills (Guilhermino et al, 2018) since breathing is a multifaceted process involving airways, lung parenchyma, muscles, the chest wall, peripheral nerves, and central nervous system. Therefore, patients on mechanical ventilation typically undergo multiorgan and multimodal monitoring (Roshdy, 2023).…”