Longhini Federico, Bruni Andrea, Garofalo Eugenio, Tutino Simona, Vetrugno Luigi, Navalesi Paolo, De Robertis Edoardo, Cammarota Gianmaria
Anesthesia and Intensive Care, Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy.
Department of Anesthesia and Intensive Care Unit, SS Annunziata Hospital, Chieti, Italy.
Front Med (Lausanne). 2023 Jan 19;9:1119924. doi: 10.3389/fmed.2022.1119924. eCollection 2022.
Patientventilator asynchrony is a major issue during non-invasive ventilation and may lead to discomfort and treatment failure. Therefore, the identification and prompt management of asynchronies are of paramount importance during non-invasive ventilation (NIV), in both pediatric and adult populations. In this review, we first define the different forms of asynchronies, their classification, and the method of quantification. We, therefore, describe the technique to properly detect patientventilator asynchronies during NIV in pediatric and adult patients with acute respiratory failure, separately. Then, we describe the actions that can be implemented in an attempt to reduce the occurrence of asynchronies, including the use of non-conventional modes of ventilation. In the end, we analyzed what the literature reports on the impact of asynchronies on the clinical outcomes of infants, children, and adults.
患者-呼吸机不同步是无创通气期间的一个主要问题,可能导致不适和治疗失败。因此,在儿科和成人患者的无创通气(NIV)过程中,识别并及时处理不同步至关重要。在本综述中,我们首先定义不同形式的不同步、其分类以及量化方法。因此,我们分别描述了在患有急性呼吸衰竭的儿科和成人患者进行无创通气期间正确检测患者-呼吸机不同步的技术。然后,我们描述了为减少不同步的发生可采取的措施,包括使用非常规通气模式。最后,我们分析了文献中关于不同步对婴儿、儿童和成人临床结局影响的报道。