Assessing the asynchrony event based on the ventilation mode for mechanically ventilated patients in ICU
Respiratory system modelling can assist clinicians in making clinical decisions during mechanical ventilation (MV) management in intensive care. However, there are some cases where the MV patients produce asynchronous breathing (asynchrony events) due to the spontaneous breathing (SB) effort even...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English English |
| Published: |
MDPI
2021
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/95228/1/95228_Assessing%20the%20asynchrony%20event%20based%20on%20the%20ventilation.pdf http://irep.iium.edu.my/95228/7/95228_Assessing%20the%20asynchrony%20event%20based%20on%20the%20ventilation_WoS.pdf http://irep.iium.edu.my/95228/ https://www.mdpi.com/journal/bioengineering |
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| Summary: | Respiratory system modelling can assist clinicians in making clinical decisions during
mechanical ventilation (MV) management in intensive care. However, there are some cases where
the MV patients produce asynchronous breathing (asynchrony events) due to the spontaneous
breathing (SB) effort even though they are fully sedated. Currently, most of the developed models
are only suitable for fully sedated patients, which means they cannot be implemented for patients
who produce asynchrony in their breathing. This leads to an incorrect measurement of the actual
underlying mechanics in these patients. As a result, there is a need to develop a model that can detect
asynchrony in real-time and at the bedside throughout the ventilated days. This paper demonstrates
the asynchronous event detection of MV patients in the ICU of a hospital by applying a developed
extended time-varying elastance model. Data from 10 mechanically ventilated respiratory failure
patients admitted at the International Islamic University Malaysia (IIUM) Hospital were collected.
The results showed that the model-based technique precisely detected asynchrony events (AEs)
throughout the ventilation days. The patients showed an increase in AEs during the ventilation
period within the same ventilation mode. SIMV mode produced much higher asynchrony compared
to SPONT mode (p < 0.05). The link between AEs and the lung elastance (AUC Edrs) was also
investigated. It was found that when the AEs increased, the AUC Edrs decreased and vice versa
based on the results obtained in this research. The information of AEs and AUC Edrs provides the
true underlying lung mechanics of the MV patients. Hence, this model-based method is capable
of detecting the AEs in fully sedated MV patients and providing information that can potentially
guide clinicians in selecting the optimal ventilation mode of MV, allowing for precise monitoring of
respiratory mechanics in MV patients. |
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