Critical care medicine · 2025
The Association Between Patient-Ventilator Asynchrony and Clinical Outcomes in Mechanically Ventilated Patients: A Systematic Review.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод пока не подготовлен
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de Bie Melissa J, Rietveld Petra J, van der Velde-Quist Franciska, van Geloven Nan, Snoep Jacob W M, de Jonge Evert, Schoe Abraham
Аннотация
OBJECTIVES: To evaluate associations between patient-ventilator asynchrony (PVA) and clinical outcome measures.
DATA SOURCES: For this systematic review, the databases of PubMed, Web of Science, Embase, Cochrane Library, and Emcare were screened until June 20, 2024.
STUDY SELECTION: The main inclusion criterion was the assessment of the association of PVA with clinical outcome measures (length of ICU stay, mechanical ventilation duration, and mortality).
DATA EXTRACTION: All forms of PVA subtypes reported in the articles were systematically collected. Furthermore, the method used to identify asynchrony and the clinical outcomes described were recorded from each study.
DATA SYNTHESIS: A total of 19 studies were included with a total of 2672 patients. The results of the meta-analysis show that overall PVA and ineffective triggering and double triggering are associated with a longer duration of mechanical ventilation (mean difference, 3.29 d; 95% CI, 0.13-6.44 d), and with a longer ICU length of stay (mean difference, 3.65 d; 95% CI, 1.20-6.11 d). No association was found between PVA and mortality. In addition, reverse triggering appears to have a potential positive association with outcome.
CONCLUSIONS: PVA and specifically ineffective triggering and double triggering, are associated with a longer duration of mechanical ventilation and longer ICU length of stay.
DATA SOURCES: For this systematic review, the databases of PubMed, Web of Science, Embase, Cochrane Library, and Emcare were screened until June 20, 2024.
STUDY SELECTION: The main inclusion criterion was the assessment of the association of PVA with clinical outcome measures (length of ICU stay, mechanical ventilation duration, and mortality).
DATA EXTRACTION: All forms of PVA subtypes reported in the articles were systematically collected. Furthermore, the method used to identify asynchrony and the clinical outcomes described were recorded from each study.
DATA SYNTHESIS: A total of 19 studies were included with a total of 2672 patients. The results of the meta-analysis show that overall PVA and ineffective triggering and double triggering are associated with a longer duration of mechanical ventilation (mean difference, 3.29 d; 95% CI, 0.13-6.44 d), and with a longer ICU length of stay (mean difference, 3.65 d; 95% CI, 1.20-6.11 d). No association was found between PVA and mortality. In addition, reverse triggering appears to have a potential positive association with outcome.
CONCLUSIONS: PVA and specifically ineffective triggering and double triggering, are associated with a longer duration of mechanical ventilation and longer ICU length of stay.