Ventilator- and interface-related factors influencing patient-ventilator asynchrony during noninvasive ventilation

Patient-ventilator asynchrony (PVA) is common in patients receiving noninvasive ventilation (NIV). This occurs primarily when the triggering and cycling-off of ventilatory assistance are not synchronized with the patient's inspiratory efforts and could result in increased work of breathing and...

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Bibliographic Details
Published in:Annals of thoracic medicine 2020-01, Vol.15 (1), p.1-8
Main Authors: Al Otair, Hadil, BaHammam, Ahmed
Format: Article
Language:English
Subjects:
air leak
Air leakage
Compensation
Complications and side effects
Evaluation
humidity
interface
Lung diseases
Mechanical ventilation
Methods
noninvasive ventilation
patient-ventilator synchrony
Patients
Physiologic monitoring
Respiratory therapy
Review
Ventilators
Ventilators (Medical equipment)
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Summary:Patient-ventilator asynchrony (PVA) is common in patients receiving noninvasive ventilation (NIV). This occurs primarily when the triggering and cycling-off of ventilatory assistance are not synchronized with the patient's inspiratory efforts and could result in increased work of breathing and niv failure. In general, five types of asynchrony can occur during NIV: ineffective inspiratory efforts, double-triggering, auto-triggering, short-ventilatory cycling, and long-ventilatory cycling. Many factors that affect PVA are mostly related to the degree of air leakage, level of pressure support, and the type and properties of the interface used. Careful monitoring and adjustment of these factors are essential to reduce PVA and improve patient comfort. In this article, we discuss the machine and interface-related factors that influence PVA during NIV and its effect on the respiratory mechanics during pressure support ventilation, which is the ventilatory mode used most commonly during NIV. For that, we critically evaluated studies that assessed ventilator- and interface-related factors that influence PVA during NIV and proposed therapeutic solutions.
ISSN:1817-1737
1998-3557
DOI:10.4103/atm.ATM_24_19