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 Longhini, Federico
A1 Colombo, Davide
A1 Pisani, Lara
A1 Idone, Francesco
A1 Chun, Pan
A1 Doorduin, Jonne
A1 Ling, Liu
A1 Alemani, Moreno
A1 Bruni, Andrea
A1 Zhaochen, Jin
A1 Tao, Yu
A1 Lu, Weihua
A1 Garofalo, Eugenio
A1 Carenzo, Luca
A1 Maggiore, Salvatore Maurizio
A1 Qiu, Haibo
A1 Heunks, Leo
A1 Antonelli, Massimo
A1 Nava, Stefano
A1 Navalesi, Paolo
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