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Framework for patient-ventilator asynchrony during long-term non-invasive ventilation
  1. Jesus Gonzalez-Bermejo1,2,
  2. Jean-Paul Janssens3,
  3. Claudio Rabec4,
  4. Christophe Perrin5,
  5. Frédéric Lofaso6,
  6. Bruno Langevin7,
  7. Annalisa Carlucci8,
  8. Manel Lujan9
  9. On behalf of the SomnoNIV group
  1. 1 UMRS1158 Neurophysiologie respiratoire expérimentale et clinique, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Paris, France
  2. 2 Groupe Hospitalier Pitié-Salpêtrière, Service de Pneumologie et Réanimation Médicale, Assistance Publique – Hopitaux de Paris, Paris, France
  3. 3 Division of Pulmonary Diseases, Geneva University Hospital, Geneva, Switzerland
  4. 4 Pulmonary Division, Centre Hospitalier Universitaire de Dijon, Dijon, France
  5. 5 Service de pneumologie, Centre Hospitalier Princesse Grace, Monaco, Monaco
  6. 6 Service de Physiologie-Explorations Fonctionnelles, AP-HP, Hôpital Raymond Poincaré, Garches, France
  7. 7 Réanimation, Pôle soins aigus, centre hospitalier Ales, Ales, France
  8. 8 Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, Pavia, Italy
  9. 9 Pneumology Department, Hospital de Sabadell, Corporació Sanitaria Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain
  1. Correspondence to Dr Jesus Gonzalez-Bermejo, UMRS1158 Neurophysiologie respiratoire expérimentale et clinique, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Paris 75013, France; jesus.gonzalez{at}aphp.fr

Abstract

Episodes of patient-ventilator asynchrony (PVA) occur during acute and chronic non-invasive positive pressure ventilation (NIV). In long-term NIV, description and quantification of PVA is not standardised, thus limiting assessment of its clinical impact. The present report provides a framework for a systematic analysis of polygraphic recordings of patients under NIV for the detection and classification of PVA validated by bench testing. The algorithm described uses two different time windows: rate asynchrony and intracycle asynchrony. This approach should facilitate further studies on prevalence and clinical impact of PVA in long-term NIV.

  • non-invasive ventilation
  • home ventilators
  • asynchrony
  • obstructive sleep apnoea
  • central sleep apnea
  • polysomnography
  • monitoring
  • sleep-disordered breathing

https://doi.org/10.1136/thoraxjnl-2018-213022

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    Footnotes

    • Correction notice This article has been corrected since it was published Online First. Figure 2 was updated.

    • Collaborators SomnoNIV group.

    • Contributors All the authors contributed in the following: substantial contributions to the conception or design of the work; or the acquisition, analysis or interpretation of data for the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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