Relationship between respiratory mechanics and patient-ventilator asynchrony index in patients with invasive mechanical ventilation

• Grant number: 15/19122-4
• Support Opportunities: Regular Research Grants
• Start date: February 01, 2016
• End date: October 31, 2018
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Juliana Carvalho Ferreira
• Grantee: Juliana Carvalho Ferreira
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• City of the host institution: São Paulo
• Associated researchers: Mayson Laércio de Araújo Sousa

Abstract

Patient-ventilator asynchrony is common in patients under invasive mechanical ventilation, present in between 10 and 80% of all respiratory cycles, and is associated with adverse clinical outcomes, such as delay in the weaning process, increased complications of mechanical ventilation, with possible impact on survival. Our objective is to estimate the incidence of asynchrony and to assess its relationship with respiratory mechanics. This will be a prospective cohort study, including all patients under invasive mechanical ventilation admitted at Respiratory ICU at Hospital das Clínicas da Faculdade de Medicina da USP, during the study period. Within 48h post intubation, we will record the values of intrinsic positive end-expiratory pressure, pulmonary compliance and resistance. Patients will be followed up from intubation to mechanical ventilation liberation. We will register clinical signs of asynchrony and record ventilator waveforms continuously. The ventilator waveforms will be captured directly from ventilator and processed by dedicated software, without direct contact with patients. Later, ventilator waveforms will be analyzed to quantify patient-ventilator asynchrony. We will calculate the total asynchrony index (AI) and of each asynchrony type (ineffective triggering, double triggering, autotriggering, short cycling and prolonged cycling). Patients will be followed up until hospital discharge, and we will record duration of mechanical ventilation, the use of non-invasive ventilation post-extubation, reintubation, tracheostomy, ICU and hospital length of stay and survival. With this project, we will estimate the incidence and magnitude of patient-ventilator asynchrony and its association with clinical outcomes. (AU)

Scientific publications

(4)

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

DE ARAUJO SOUSA, MAYSON LAERCIO; MAGRANS, RUDYS; HAYASHI, FATIMA K.; BLANCH, LLUIS; KACMAREK, R. M.; FERREIRA, JULIANA C.. EPISYNC study: predictors of patient-ventilator asynchrony in a prospective cohort of patients under invasive mechanical ventilation - study protocol. BMJ OPEN, v. 9, n. 5, MAY 2019. (15/19122-4)

DE ARAUJO SOUSA, MAYSON LAERCIO; MAGRANS, RUDYS; HAYASHI, FATIMA K.; BLANCH, LLUIS; KACMAREK, ROBERT M.; FERREIRA, JULIANA C.. Predictors of asynchronies during assisted ventilation and its impact on clinical outcomes: The EPISYNC cohort study. JOURNAL OF CRITICAL CARE, v. 57, p. 30-35, JUN 2020. (15/19122-4)

DE ARAUJO SOUSA, MAYSON LAERCIO; MAGRANS, RUDYS; HAYASHI, FATIMA K.; BLANCH, LLUIS; KACMAREK, ROBERT M.; FERREIRA, JULIANA C.. Response to the letter: Esophageal pressure and potential confounders for evaluating patient-ventilator asynchrony. JOURNAL OF CRITICAL CARE, v. 60, p. 345-346, DEC 2020. (15/19122-4)

SOUSA, MAYSON LAERCIOD E. ARAUJO; MAGRANS, RUDYS; HAYASHI, FATIMA K.; BLANCH, LLUIS; KACMAREK, ROBERT M.; FERREIRA, JULIANA C.. lusters of Double Triggering Impact Clinical Outcomes: Insights From the EPIdemiology of Patient-Ventilator aSYNChrony (EPISYNC) Cohort Stud. Critical Care Medicine, v. 49, n. 9, p. 1460-1469, SEP 2021. (15/19122-4)