Patient-Ventilator Interaction in the Long-Term Acute-Care Hospital

• Published in: Respiratory care 2011-02, Vol.56 (2), p.207-213
• Main Authors: GHAMLOUSH, Maher, O'CONNOR, Heidi H, WHITE, Alexander C
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anxiety - prevention & control; Artificial respiration; Biological and medical sciences; Care and treatment; Clinical death. Palliative care. Organ gift and preservation; Delirium - prevention & control; Depression - prevention & control; Health aspects; Hospital patients; Humans; Intensive care medicine; Long-Term Care; Medical sciences; Physiological aspects; Respiration; Respiration, Artificial; Respiratory Insufficiency - physiopathology; Respiratory Insufficiency - therapy; Risk Factors; Tracheostomy; Ventilator Weaning; Ventilators, Mechanical; Work of Breathing - physiology
• ISSN: 0020-1324; 1943-3654
• DOI: 10.4187/respcare.01084

Optimizing patient-ventilator synchrony is essential in managing patients who require prolonged mechanical ventilation in the long-term acute-care hospital. Inadequate synchrony can increase work of breathing, cause patient discomfort, and delay both weaning and general rehabilitation. Achieving optimal synchrony in the long-term acute-care hospital depends on a number of factors, including adjusting ventilator settings in response to improving lung function; adjusting psychotropic medications to control delirium, anxiety, and depression; and ensuring there is a well positioned correctly sized tracheostomy tube in the airway. The purpose of this review is to provide an update on issues pertinent to patient-ventilator synchrony in the LTACH setting.