Asynchrony Consequences and Management

被引:66
作者
Pham, Tai [1 ,2 ]
Telias, Irene [1 ,2 ]
Piraino, Thomas [3 ]
Yoshida, Takeshi [1 ,2 ,4 ,5 ]
Brochard, Laurent J. [1 ,2 ]
机构
[1] Univ Toronto, St Michaels Hosp, Interdept Div Crit Care Med, 30 Bond St, Toronto, ON M5B 1W8, Canada
[2] St Michaels Hosp, Li Ka Shing Knowledge Inst, Keenan Res Ctr Biomed Sci, 209 Victoria St, Toronto, ON M5B 1T8, Canada
[3] St Michaels Hosp, Dept Resp Therapy, 30 Bond St, Toronto, ON M5B 1W8, Canada
[4] Univ Toronto, Hosp Sick Children, Dept Crit Care Med, Translat Med, 555 Univ Ave, Toronto, ON M5G 1X8, Canada
[5] Univ Toronto, Hosp Sick Children, Dept Anesthesia, Translat Med, 555 Univ Ave, Toronto, ON M5G 1X8, Canada
基金
日本学术振兴会;
关键词
Mechanical ventilation; Dyssynchrony; Airway pressure; Monitoring; Work of breathing; PROPORTIONAL-ASSIST VENTILATION; PRESSURE-SUPPORT VENTILATION; RESPIRATORY-DISTRESS-SYNDROME; CRITICALLY-ILL PATIENTS; MECHANICAL VENTILATION; LUNG INJURY; INEFFECTIVE EFFORTS; BREATH STACKING; SLEEP QUALITY; TIDAL VOLUME;
D O I
10.1016/j.ccc.2018.03.008
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Poor synchrony between the delivery of mechanical breaths, the neural respiratory timing, and needs of patients is relatively frequent under me-chanical ventilation in the intensive care unit. This article summarizes the current knowledge on the different types of dyssynchrony described to date and their mechanism, consequences, and potential management. There is still a long way to get to a comprehensive knowledge, and uncertainties remain. Ongoing research and development of monitoring tools are urgently needed to allow a better appraisal of this area.
引用
收藏
页码:325 / +
页数:18
相关论文
共 63 条
[1]   Mechanical Ventilation-Induced Reverse-Triggered Breaths A Frequently Unrecognized Form of Neuromechanical Coupling [J].
Akoumianaki, Evangelia ;
Lyazidi, Aissam ;
Rey, Nathalie ;
Matamis, Dimitrios ;
Perez-Martinez, Nelly ;
Giraud, Raphael ;
Mancebo, Jordi ;
Brochard, Laurent ;
Richard, Jean-Christophe Marie .
CHEST, 2013, 143 (04) :927-938
[2]   Patient-ventilator synchrony and sleep quality with proportional assist and pressure support ventilation [J].
Alexopoulou, C. ;
Kondili, E. ;
Plataki, M. ;
Georgopoulos, D. .
INTENSIVE CARE MEDICINE, 2013, 39 (06) :1040-1047
[3]   Effects of flow triggering on breathing effort during partial ventilatory support [J].
Aslanian, P ;
El Atrous, S ;
Isabey, D ;
Valente, E ;
Corsi, D ;
Harf, A ;
Lemaire, F ;
Brochard, L .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1998, 157 (01) :135-143
[4]   Quantifying unintended exposure to high tidal volumes from breath stacking dyssynchrony in ARDS: the BREATHE criteria [J].
Beitler, Jeremy R. ;
Sands, Scott A. ;
Loring, Stephen H. ;
Owens, Robert L. ;
Malhotra, Atul ;
Spragg, Roger G. ;
Matthay, Michael A. ;
Thompson, B. Taylor ;
Talmor, Daniel .
INTENSIVE CARE MEDICINE, 2016, 42 (09) :1427-1436
[5]   Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries [J].
Bellani, Giacomo ;
Laffey, John G. ;
Pham, Tai ;
Fan, Eddy ;
Brochard, Laurent ;
Esteban, Andres ;
Gattinoni, Luciano ;
van Haren, Frank ;
Larsson, Anders ;
McAuley, Daniel F. ;
Ranieri, Marco ;
Rubenfeld, Gordon ;
Thompson, B. Taylor ;
Wrigge, Hermann ;
Slutsky, Arthur S. ;
Pesenti, Antonio .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2016, 315 (08) :788-800
[6]   Lung-brain cross talk in the critically ill [J].
Blanch, Lluis ;
Quintel, Michael .
INTENSIVE CARE MEDICINE, 2017, 43 (04) :557-559
[7]   Asynchronies during mechanical ventilation are associated with mortality [J].
Blanch, Lluis ;
Villagra, Ana ;
Sales, Bernat ;
Montanya, Jaume ;
Lucangelo, Umberto ;
Lujan, Manel ;
Garcia-Esquirol, Oscar ;
Chacon, Encarna ;
Estruga, Anna ;
Oliva, Joan C. ;
Hernandez-Abadia, Alberto ;
Albaiceta, Guillermo M. ;
Fernandez-Mondejar, Enrique ;
Fernandez, Rafael ;
Lopez-Aguilar, Josefina ;
Villar, Jesus ;
Murias, Gaston ;
Kacmarek, Robert M. .
INTENSIVE CARE MEDICINE, 2015, 41 (04) :633-641
[8]   Validation of the Better CareA® system to detect ineffective efforts during expiration in mechanically ventilated patients: a pilot study [J].
Blanch, Lluis ;
Sales, Bernat ;
Montanya, Jaume ;
Lucangelo, Umberto ;
Garcia-Esquirol, Oscar ;
Villagra, Ana ;
Chacon, Encarna ;
Estruga, Anna ;
Borelli, Massimo ;
Jose Burgueno, Ma ;
Oliva, Joan C. ;
Fernandez, Rafael ;
Villar, Jesus ;
Kacmarek, Robert ;
Murias, Gaston .
INTENSIVE CARE MEDICINE, 2012, 38 (05) :772-780
[9]   Patient-ventilator interaction and sleep in mechanically ventilated patients: Pressure support versus proportional assist ventilation [J].
Bosma, Karen ;
Ferreyra, Gabriela ;
Ambrogio, Cristina ;
Pasero, Daniela ;
Mirabella, Lucia ;
Braghiroli, Alberto ;
Appendini, Lorenzo ;
Mascia, Luciana ;
Ranieri, V. Marco .
CRITICAL CARE MEDICINE, 2007, 35 (04) :1048-1054
[10]   Mechanical Ventilation to Minimize Progression of Lung Injury in Acute Respiratory Failure [J].
Brochard, Laurent ;
Slutsky, Arthur ;
Pesenti, Antonio .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2017, 195 (04) :438-442