Identifying and managing patient–ventilator asynchrony: An international survey.

Abstract

Objective: To describe the main factors associated with proper recognition and management of patient ventilator asynchronies (PVA). Design: Analytical cross-sectional study. Setting: International study conducted in 20 countries through an online survey. Participants: Physicians, respiratory therapists, nurses and physiotherapists that are currently working at the Intensive Care Unit (ICU). Main variables of interest: Univariate and multivariate logistic regression models were used to establish associations between all variables (profession, training in mechanical ventilation, type of training program, years of experience and ICU characteristics) with the ability of HCPs to correctly identify and manage 6 PVA. Results: A total of 431 HCPs answered a validated survey. The main factors associated with the proper recognition of PVA were: specific training program in mechanical ventilation (MV) (OR 2.27; 95% CI 1.14-4.52; p = 0.019), courses with more than 100 hours completed (OR 2.28; 95% CI 1.29-4.03; p = 0.005) and the number of intensive care unit (ICU) beds (OR 1.037; 95% CI 1.01-1.06; p = 0.005). The main factor that influenced PVA management was recognizing 6 PVA correctly (OR 118.98; 95%CI 35.25-401.58; p < 0.001). Conclusion: Identifying and managing PVA using ventilator waveform analysis is influenced by many factors including specific training programs in MV, number of ICU beds and the recognized number of PVA.