Asynchrony Consequences and Management

Tài Pham; Irene Telias; Thomas Piraino; Takeshi Yoshida; Laurent J Brochard

doi:10.1016/j.ccc.2018.03.008

Asynchrony Consequences and Management

Crit Care Clin. 2018 Jul;34(3):325-341. doi: 10.1016/j.ccc.2018.03.008.

Authors

Tài Pham¹, Irene Telias¹, Thomas Piraino², Takeshi Yoshida³, Laurent J Brochard⁴

Affiliations

¹ Interdepartmental Division of Critical Care Medicine, University of Toronto, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada; Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada.
² Department of Respiratory Therapy, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada.
³ Interdepartmental Division of Critical Care Medicine, University of Toronto, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada; Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada; Translational Medicine, Departments of Critical Care Medicine and Anesthesia, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON M5G 1X8, Canada.
⁴ Interdepartmental Division of Critical Care Medicine, University of Toronto, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada; Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada. Electronic address: BrochardL@smh.ca.

PMID: 29907268
DOI: 10.1016/j.ccc.2018.03.008

Abstract

Poor synchrony between the delivery of mechanical breaths, the neural respiratory timing, and needs of patients is relatively frequent under mechanical ventilation in the intensive care unit. This review summarizes the current knowledge on the different types of dyssynchrony described to date, 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 in a near future.

Keywords: Airway pressure; Dyssynchrony; Mechanical ventilation; Monitoring; Work of breathing.

Publication types

Review

MeSH terms

Air Pressure
Humans
Monitoring, Physiologic
Respiration, Artificial / adverse effects*
Respiration, Artificial / methods
Respiratory Mechanics / physiology*
Treatment Outcome
Work of Breathing