What is meant by the expression “patient – ventilator dys-synchrony”?
What are the principles of managing this problem?
Patient-ventilator dys-synchrony refers to the situation in which the patient fails to achieve comfortable respiration in synchrony with the ventilator in terms of timing of inspiration, adequate inspiratory flow for demand, timing of the switch to expiration and duration of inspiration.
Managing this problem may be addressed by –
• treating patient respiratory problems eg sputum, irritable airways
• checking ETT for kinking, secretion block, impinging on carina or between cords
• choosing the appropriate ventilator
• choosing the appropriate mode
• selecting sensitivity not too low or high
• choosing the appropriate ventilator rate
• setting appropriate flow rate
• sedating the patient to reduce agitation
• taking over ventilation if fatigue is apparent
Patient-ventilator dyssynchrony is discussed elsewhere. In essence, it is increased work of breathing and decreased patient comfort because of a mismatch between the ventilator gas delivery pattern and the patient's demands.
One can manage patient-ventilator dyssynchrony by