Identifying asynchronies: Delayed cycling

Víctor Perez, Jamille Pasco

Abstract

Patient-ventilator asynchrony/dysynchrony is a mismatch between the patient and the ventilator’s delivered breaths and the ability of the ventilator to meet the patient demands.

Any factor that alters the harmony between these two components produces asynchrony, which can cause discomfort and an increase in the patient’s work of breathing.

Delayed cycling occurs when the neural time is less than the mechanical time of the ventilator.

Keywords

Patient-Ventilator synchrony, ventilator, delayed cycling, work of breathing, neural time, mechanical time

References

1. Sassoon CS, Foster GT. Patient-ventilator asynchrony. Curr Opin Crit Care 2001; 7:28-33. https://doi.org/10.1097/00075198-200102000-00005 PMid:11373508

2. Kondili E, Prinianakis G, Georgopoulos D. Patient-ventilator interaction. Br J Anaesth 2003; 91(1):106-119. https://doi.org/10.1093/bja/aeg129 PMid:12821570

3. Nilsestuen JO, Hargett KD. Using ventilator graphics to identify patient-ventilator asynchrony. Respir Care 2005; 50(2):202-234. PMID: 15691392

4. Thille AW, Rodriguez P, Cabello B, et al. Patient-ventilator asynchrony during assisted mechanical ventilation. Intensive Care Med 2006; 32:1515-1522. https://doi.org/10.1007/s00134-006-0301-8 PMid:16896854

5. Mireles-Cabodevila E, Siuba MT, Chatburn RL. A Taxonomy for patient-ventilator interactions and a method to read ventilator waveforms. Respir Care 2022; 67(1):129-148. https://doi.org/10.4187/respcare.09316 PMid:34470804

6. Mirabella L, Cinnella G, Costa R, et al. Patient-ventilator asynchronies: clinical implications and practical. Respir Care 2020; 65(11):1751-1766. https://doi.org/10.4187/respcare.07284 PMid:32665426

7. Ranieri VM, Squadrone V, Appendini L, et al. Patient-ventilator interaction. In Vincent JL, Abraham E, Moore FA, Kochanek PM, Fink MP. Textbook of critical care. 7th ed. Philadelphia: Elsevier; 2017; 366-372.

8. Bonetto C, Calo MN, Delgado MO, et al. Modes of pressure delivery and patient-ventilator interaction. Respir Care Clin N Am 2005; 11:247-263. https://doi.org/10.1016/j.rcc.2005.01.002 PMid:15936692