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Intensive Care Medicine
Published in: Intensive Care Medicine 1/2006

01-01-2006 | Review

Bedside waveforms interpretation as a tool to identify patient-ventilator asynchronies

Authors: Dimitris Georgopoulos, George Prinianakis, Eumorfia Kondili

Published in: Intensive Care Medicine | Issue 1/2006

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Abstract

Objective

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.

Discussion

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.

Conclusions

Flow, volume, and airway pressure waveforms are valuable real-time tools in identifying various aspects of patient-ventilator interaction
Appendix
Available only for authorised users
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Metadata
Title
Bedside waveforms interpretation as a tool to identify patient-ventilator asynchronies
Authors
Dimitris Georgopoulos
George Prinianakis
Eumorfia Kondili
Publication date
01-01-2006
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 1/2006
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-005-2828-5

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