ArticleAnnals of intensive care2017
Patient-ventilator asynchrony during conventional mechanical ventilation in children.
Article in Annals of intensive care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Closed-loop synchronization versus conventional synchronization in spontaneously breathing pediatric patients (CHESTSIPP) - a randomized controlled cross-over study.Frontiers in medicine · 2026Trial
- Nurses` perspectives on early mobilization of intubated children in the pediatric intensive care unit: a qualitative study of barriers and facilitators.Frontiers in pediatrics · 2026Article
- Asynchrony index modified: An improved tool for estimating the quality of patient-ventilator interaction.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2026Article
- An overview of patient-ventilator asynchrony in children.Expert review of respiratory medicine · 2025Review
- Association of diaphragmatic dysfunction with duration of mechanical ventilation in patients in the pediatric intensive care unit: a prospective cohort study.BMC pediatrics · 2024Article
- Detection and quantitative analysis of patient-ventilator interactions in ventilated infants by deep learning networks.Pediatric research · 2024Observational
- Respiratory entrainment related reverse triggering in mechanically ventilated children.Respiratory research · 2024Article
- The Impact of a Training Intervention on Detection of Patient-Ventilator Asynchronies in Nursing Students.Acta bio-medica : Atenei Parmensis · 2022Article
- A narrative review of advanced ventilator modes in the pediatric intensive care unit.Translational pediatrics · 2021Review
- Neurally-Adjusted Ventilatory Assist (NAVA) versus Pneumatically Synchronized Ventilation Modes in Children Admitted to PICU.Journal of clinical medicine · 2021Review
- Not All Breaths That Follow a Ventilator Cycle Are Reverse Triggering.Annals of the American Thoracic Society · 2021Article
- Additional work of breathing from trigger errors in mechanically ventilated children.Respiratory research · 2020Observational
- Pressure Support Ventilation (PSV) versus Neurally Adjusted Ventilatory Assist (NAVA) in difficult to wean pediatric ARDS patients: a physiologic crossover study.BMC pediatrics · 2020Article
- Neurally adjusted ventilatory assist vs. pressure support to deliver protective mechanical ventilation in patients with acute respiratory distress syndrome: a randomized crossover trial.Annals of intensive care · 2020Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe aimed (1) to describe the characteristics of patient-ventilator asynchrony in a population of critically ill children, (2) to describe the risk factors associated with patient-ventilator asynchrony, and (3) to evaluate the association between patient-ventilator asynchrony and ventilator-free days at day 28.
methodsIn this single-center prospective study, consecutive children admitted to the PICU and mechanically ventilated for at least 24 h were included. Patient-ventilator asynchrony was analyzed by comparing the ventilator pressure curve and the electrical activity of the diaphragm (Edi) signal with (1) a manual analysis and (2) using a standardized fully automated method.
resultsFifty-two patients (median age 6 months) were included in the analysis. Eighteen patients had a very low ventilatory drive (i.e., peak Edi < 2 µV on average), which prevented the calculation of patient-ventilator asynchrony. Children spent 27% (interquartile 22-39%) of the time in conflict with the ventilator. Cycling-off errors and trigger delays contributed to most of this asynchronous time. The automatic algorithm provided a NeuroSync index of 45%, confirming the high prevalence of asynchrony. No association between the severity of asynchrony and ventilator-free days at day 28 or any other clinical secondary outcomes was observed, but the proportion of children with good synchrony was very low.
conclusionPatient-ventilator interaction is poor in children supported by conventional ventilation, with a high frequency of depressed ventilatory drive and a large proportion of time spent in asynchrony. The clinical benefit of strategies to improve patient-ventilator interactions should be evaluated in pediatric critical care.
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