RT Journal Article
SR Electronic
T1 Efficacy of ventilator waveform observation for detection of patient–ventilator asynchrony during NIV: a multicentre study
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00075-2017
DO 10.1183/23120541.00075-2017
VO 3
IS 4
A1 Federico Longhini
A1 Davide Colombo
A1 Lara Pisani
A1 Francesco Idone
A1 Pan Chun
A1 Jonne Doorduin
A1 Liu Ling
A1 Moreno Alemani
A1 Andrea Bruni
A1 Jin Zhaochen
A1 Yu Tao
A1 Weihua Lu
A1 Eugenio Garofalo
A1 Luca Carenzo
A1 Salvatore Maurizio Maggiore
A1 Haibo Qiu
A1 Leo Heunks
A1 Massimo Antonelli
A1 Stefano Nava
A1 Paolo Navalesi
YR 2017
UL http://openres.ersjournals.com/content/3/4/00075-2017.abstract
AB The objective of this study was to assess ability to identify asynchronies during noninvasive ventilation (NIV) through ventilator waveforms according to experience and interface, and to ascertain the influence of breathing pattern and respiratory drive on sensitivity and prevalence of asynchronies.35 expert and 35 nonexpert physicians evaluated 40 5-min NIV reports displaying flow–time and airway pressure–time tracings; identified asynchronies were compared with those ascertained by three examiners who evaluated the same reports displaying, additionally, tracings of diaphragm electrical activity. We determined: 1) sensitivity, specificity, and positive and negative predictive values; 2) the correlation between the double true index (DTI) of each report (i.e., the ratio between the sum of true positives and true negatives, and the overall breath count) and the corresponding asynchrony index (AI); and 3) the influence of breathing pattern and respiratory drive on both AI and sensitivity.Sensitivities to detect asynchronies were low either according to experience (0.20 (95% CI 0.14–0.29) for expert versus 0.21 (95% CI 0.12–0.30) for nonexpert, p=0.837) or interface (0.28 (95% CI 0.17–0.37) for mask versus 0.10 (95% CI 0.05–0.16) for helmet, p<0.0001). DTI inversely correlated with the AI (r2=0.67, p<0.0001). Breathing pattern and respiratory drive did not affect prevalence of asynchronies and sensitivity.Patient–ventilator asynchrony during NIV is difficult to recognise solely by visual inspection of ventilator waveforms.Detection of patient–ventilator asynchrony during NIV by visual inspection of ventilator waveforms is difficult http://ow.ly/3ce930eGdn6