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ISSN 2448-8909 (Print)

2019, Number 6

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Med Crit 2019; 33 (6)

Impact of asynchronies on the prognosis of the ventilated patient

Morales MAH, Gasca AJC, Castillo MKJ, Sosa SS

Language: Portugués
References: 20
Page: 328-333
PDF size: 223.29 Kb.


ABSTRACT

High incidence of patient-ventilator asynchrony could modify patient prognostic. Although there is a 10 to 85% rate incidence they are not frequently diagnosed. Asynchronies occur when there is a mismatch between time, flow, volume and pressure patient respiratory demands and ventilator setting, they are classified according to respiratory cycle time, most common types are ineffective effort (IE) and double triggering (DD). Asynchrony is associated to worst outcomes, related to discomfort and dyspnea that leads to increasing wasting expenditure energy and abnormal diaphragmatic pattern associated to respiratory muscles damage as well as increasing risk of delirium which results in difficult weaning, deep sedation and use of neuromuscular blockers, longer duration of mechanical ventilation, longer stay in UCI, increasing need of tracheotomy and higher mortality. There is not enough evidence that supports if detection and treatment of asynchronies may improve outcomes or if they belong to a severity marker that represents respiratory and mechanical alterations.


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