Patient-ventilator dyssynchronies: Are they all the same? A clinical classification to guide actions.

Publisher: W.B. Saunders Country of Publication: United States NLM ID: 8610642 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-8615 (Electronic) Linking ISSN: 08839441 NLM ISO Abbreviation: J Crit Care Subsets: MEDLINE

Publication: Philadelphia Pa : W.B. Saunders
Original Publication: Orlando, FL : Grune & Stratton, c1986-

Ventilators, Mechanical*; Critical Care/*methods ; Deep Sedation/*methods ; Hypnotics and Sedatives/*administration & dosage ; Respiration, Artificial/*adverse effects ; Respiratory Mechanics/*drug effects; Critical Illness ; Humans ; Maximal Respiratory Pressures ; Mental Disorders ; Prognosis

Patient ventilatory dyssynchrony (PVD) is a mismatch between the respiratory drive of the patient and ventilatory assistance. It is a complex event seen in almost all ventilated patients and at any ventilator mode, with uncertain significance and prognosis. Due to its different pathophysiological mechanisms, there is still not consensual classification to guide us in selecting the best treatment. In the present review we aimed to summarize some clinical data on PVD, and to propose a clinical classification based on the type of PVD, from potentially innocuous to clearly harmful PVD, which could help clinicians in the decision-making process from adjusting ventilator settings to deeply sedate or paralyze the patient. Clearly, further studies are needed addressing risk factors, physiologic mechanisms and direct consequences of PVD in order to help clinicians to design effective and proven strategies at the bedside.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2020 Elsevier Inc. All rights reserved.)

0 (Hypnotics and Sedatives)

Date Created: 20200803 Date Completed: 20210520 Latest Revision: 20210520

20221213

10.1016/j.jcrc.2020.07.016

32739760