Bedside waveforms interpretation as a tool to identify patient-ventilator asynchronies
During assisted modes of ventilatory support the ventilatory output is the final expression of the interaction between the ventilator and the patient's controller of breathing. This interaction may lead to patient-ventilator asynchrony, preventing the ventilator from achieving its goals, and ma...
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| Veröffentlicht in: | Intensive care medicine 2006, Vol.32 (1), p.34-47 |
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| creator | GEORGOPOULOS, Dimitris PRINIANAKIS, George KONDILI, Eumorfia |
| description | During assisted modes of ventilatory support the ventilatory output is the final expression of the interaction between the ventilator and the patient's controller of breathing. This interaction may lead to patient-ventilator asynchrony, preventing the ventilator from achieving its goals, and may cause patient harm. Flow, volume, and airway pressure signals are significantly affected by patient-ventilator interaction and may serve as a tool to guide the physician to take the appropriate action to improve the synchrony between patient and ventilator. This review discusses the basic waveforms during assisted mechanical ventilation and how their interpretation may influence the management of ventilated patients. The discussion is limited on waveform eye interpretation of the signals without using any intervention which may interrupt the process of mechanical ventilation.
Flow, volume, and airway pressure may be used to (a) identify the mode of ventilator assistance, triggering delay, ineffective efforts, and autotriggering, (b) estimate qualitatively patient's respiratory efforts, and (c) recognize delayed and premature opening of exhalation valve. These signals may also serve as a tool for gross estimation of respiratory system mechanics and monitor the effects of disease progression and various therapeutic interventions.
Flow, volume, and airway pressure waveforms are valuable real-time tools in identifying various aspects of patient-ventilator interaction. |
| doi_str_mv | 10.1007/s00134-005-2828-5 |
| format | Article |
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Flow, volume, and airway pressure may be used to (a) identify the mode of ventilator assistance, triggering delay, ineffective efforts, and autotriggering, (b) estimate qualitatively patient's respiratory efforts, and (c) recognize delayed and premature opening of exhalation valve. These signals may also serve as a tool for gross estimation of respiratory system mechanics and monitor the effects of disease progression and various therapeutic interventions.
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Flow, volume, and airway pressure may be used to (a) identify the mode of ventilator assistance, triggering delay, ineffective efforts, and autotriggering, (b) estimate qualitatively patient's respiratory efforts, and (c) recognize delayed and premature opening of exhalation valve. These signals may also serve as a tool for gross estimation of respiratory system mechanics and monitor the effects of disease progression and various therapeutic interventions.
Flow, volume, and airway pressure waveforms are valuable real-time tools in identifying various aspects of patient-ventilator interaction.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Artificial respiration</subject><subject>Biological and medical sciences</subject><subject>Clinical death. Palliative care. 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Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Artificial respiration</topic><topic>Biological and medical sciences</topic><topic>Clinical death. Palliative care. Organ gift and preservation</topic><topic>Data Display</topic><topic>Emergency and intensive respiratory care</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Mechanics</topic><topic>Medical sciences</topic><topic>Monitoring, Physiologic</topic><topic>Patients</topic><topic>Point-of-Care Systems</topic><topic>Positive-Pressure Respiration - instrumentation</topic><topic>Positive-Pressure Respiration - methods</topic><topic>Pulmonary Ventilation - physiology</topic><topic>Respiration</topic><topic>Respiratory Mechanics</topic><topic>Respiratory system</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GEORGOPOULOS, Dimitris</creatorcontrib><creatorcontrib>PRINIANAKIS, George</creatorcontrib><creatorcontrib>KONDILI, Eumorfia</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GEORGOPOULOS, Dimitris</au><au>PRINIANAKIS, George</au><au>KONDILI, Eumorfia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bedside waveforms interpretation as a tool to identify patient-ventilator asynchronies</atitle><jtitle>Intensive care medicine</jtitle><addtitle>Intensive Care Med</addtitle><date>2006</date><risdate>2006</risdate><volume>32</volume><issue>1</issue><spage>34</spage><epage>47</epage><pages>34-47</pages><issn>0342-4642</issn><eissn>1432-1238</eissn><coden>ICMED9</coden><abstract>During assisted modes of ventilatory support the ventilatory output is the final expression of the interaction between the ventilator and the patient's controller of breathing. This interaction may lead to patient-ventilator asynchrony, preventing the ventilator from achieving its goals, and may cause patient harm. Flow, volume, and airway pressure signals are significantly affected by patient-ventilator interaction and may serve as a tool to guide the physician to take the appropriate action to improve the synchrony between patient and ventilator. This review discusses the basic waveforms during assisted mechanical ventilation and how their interpretation may influence the management of ventilated patients. The discussion is limited on waveform eye interpretation of the signals without using any intervention which may interrupt the process of mechanical ventilation.
Flow, volume, and airway pressure may be used to (a) identify the mode of ventilator assistance, triggering delay, ineffective efforts, and autotriggering, (b) estimate qualitatively patient's respiratory efforts, and (c) recognize delayed and premature opening of exhalation valve. These signals may also serve as a tool for gross estimation of respiratory system mechanics and monitor the effects of disease progression and various therapeutic interventions.
Flow, volume, and airway pressure waveforms are valuable real-time tools in identifying various aspects of patient-ventilator interaction.</abstract><cop>Heidelberg</cop><cop>Berlin</cop><pub>Springer</pub><pmid>16283171</pmid><doi>10.1007/s00134-005-2828-5</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Artificial respiration Biological and medical sciences Clinical death. Palliative care. Organ gift and preservation Data Display Emergency and intensive respiratory care Humans Intensive care medicine Mechanics Medical sciences Monitoring, Physiologic Patients Point-of-Care Systems Positive-Pressure Respiration - instrumentation Positive-Pressure Respiration - methods Pulmonary Ventilation - physiology Respiration Respiratory Mechanics Respiratory system Ventilators |
| title | Bedside waveforms interpretation as a tool to identify patient-ventilator asynchronies |
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