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Patient-ventilator asynchrony

Murias, Gaston; Lucangelo, Umberto; Blanch, Lluis

Current Opinion in Critical Care: February 2016 - Volume 22 - Issue 1 - p 53–59
doi: 10.1097/MCC.0000000000000270
RESPIRATORY SYSTEM: Edited by Marco Ranieri

Purpose of review The purpose of the review is to alert clinicians to the prevalent and frequently underrecognized problem of asynchrony in mechanically ventilated patients. To provide a mechanistic model of patient-ventilator asynchrony to help personnel understand how different asynchronies develop. To provide practical advice on how to recognize and solve different asynchronies in different contexts.

Recent findings Patient-ventilator asynchrony is a serious problem that is associated with prolonged mechanical ventilation, prolonged ICU and hospital stays, and increased mortality. Asynchronies can occur in all modes of invasive and noninvasive ventilation in all care contexts.

Summary The review provides insights into the causes of patient-ventilator asynchrony and mechanisms involved in the development of specific types of asynchrony. It explores the effects of sedation on the development of asynchrony and the impact of new ventilator modes. It also discusses the prevalence of asynchrony and its effects on outcome.

aClínica Bazterrica y Clínica Santa Isabel, Buenos Aires, Argentina

bDepartment of Perioperative Medicine, Intensive Care and Emergency, Cattinara Hospital, Trieste University, Trieste, Italy

cCritical Care Center, Hospital de Sabadell, Corporació Sanitaria Universitària Parc Taulí, Universitat Autònoma de Barcelona, Sabadell

dCIBER Enfermedades Respiratorias, ISCIII, Madrid

eInstitut de Investigació i Innovació Parc Taulí, I3PT, Sabadell, Spain

Correspondence to Gaston Murias, Clínica Bazterrica y Clínica Santa Isabel, 517 bis #1096 entre 5bis y 7, (1901) Ringuelet (La Plata), Buenos Aires, Argentina. Tel: +54 9 11 4474 2329; e-mail:

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