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Patient–Ventilator Interactions and Asynchrony 

Patient–Ventilator Interactions and Asynchrony
Chapter:
Patient–Ventilator Interactions and Asynchrony
Author(s):

John W. Kreit

DOI:
10.1093/med/9780190670085.003.0011
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date: 18 August 2019

Patient–Ventilator Interactions and Asynchrony describes what happens when the patient and the ventilator do not work together in an effective, coordinated manner. Effective mechanical ventilation requires the synchronized function of two pumps: The mechanical ventilator is governed by the settings chosen by the clinician; the patient’s respiratory system is controlled by groups of neurons in the brain stem. Ideally, the ventilator simply augments and amplifies the activity of the respiratory system. Asynchrony between the ventilator and the patient reduces patient comfort, increases work of breathing, predisposes to respiratory muscle fatigue, and may even impair oxygenation and ventilation. The chapter describes the causes and consequences of patient–ventilator asynchrony during ventilator triggering and the inspiratory phase of the respiratory cycle and explains how to adjust ventilator settings to improve patient comfort and reduce the work of breathing.

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