An automated classification algorithm for the detection of expiratory ineffective efforts in patient-ventilator interaction is developed and validated. Using this algorithm, 5624 breaths from 23 patients in a pulmonary ward were examined. The participants (N = 23) underwent both conventional and non-invasive ventilation. Tracings of patient flow, pressure at the airway, and transdiaphragmatic pressure were manually labeled by an expert. Overall accuracy of 94.5% was achieved with sensitivity 58.7% and specificity 98.7%. The results demonstrate the viability of using pattern classification techniques to automatically detect the presence of asynchrony between a patient and their ventilator.
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http://dx.doi.org/10.1109/IEMBS.2009.5332684 | DOI Listing |
J Clin Med
January 2025
Department of Critical Care Medicine, Hospital de São Francisco Xavier, Unidade Local de Saúde Lisboa Ocidental (ULSLO), Estrada Forte do Alto Duque, 1449-005 Lisbon, Portugal.
The prompt identification and correction of patient-ventilator asynchronies (PVA) remain a cornerstone for ensuring the quality of respiratory failure treatment and the prevention of further injury to critically ill patients. These disruptions, whether due to over- or under-assistance, have a profound clinical impact not only on the respiratory mechanics and the mortality associated with mechanical ventilation but also on the patient's cardiac output and hemodynamic profile. Strong evidence has demonstrated that these frequently occurring and often underdiagnosed events have significant prognostic value for mechanical ventilation outcomes and are strongly associated with prolonged ICU stays and hospital mortality.
View Article and Find Full Text PDFAm J Respir Crit Care Med
November 2024
University of Trento, Cismed, Trento, Italy.
Curr Opin Crit Care
February 2025
Department of Medicine, Section of Pulmonary and Critical Care, University of Chicago, Chicago, Illinois, USA.
Curr Opin Crit Care
February 2025
Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, Unity Health Toronto.
Purpose Of Review: Past observational studies have reported the association between patient-ventilator asynchronies and poor clinical outcomes, namely longer duration of mechanical ventilation and higher mortality. But causality has remained undetermined. During the era of lung and diaphragm protective ventilation, should we revolutionize our clinical practice to detect and treat dyssynchrony?
Recent Findings: Clinicians' ability to recognize asynchronies is typically low.
J Matern Fetal Neonatal Med
December 2024
Graduate School of Nursing Sciences, Global Health Nursing, St Luke's International University, Tokyo, Japan.
Background: Noninvasive neurally-adjusted ventilatory assist (NIV-NAVA) improves patient-ventilator synchrony and may reduce treatment failure in preterm infants compared with nasal continuous positive airway pressure (NCPAP) and noninvasive positive-pressure ventilation (NIPPV). We conducted a systematic review and meta-analysis to assess the effects of NIV-NAVA in preterm infants with respiratory distress.
Methods: Four investigators independently assessed the eligibility of studies in CENTRAL, CINAHL, ClinicalTrials.
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