Modulation and treatment of patient-ventilator dyssynchrony.
OBJECTIVE
The coupling between ventilator delivered inspiratory flow and patient's demands both in terms of timing and drive is a challenging task that has become largely feasible in recent years. This review addresses the new advances to modulate and treat patient-ventilator dyssynchrony.


RESULTS
Patient-ventilator dyssynchrony is a common phenomenon with conventional modes of mechanical ventilation which influence the duration of mechanical ventilation. Inspection of pressure, volume and flow waveforms represents a valuable tool for the physician to recognize and take the appropriate action to improve patient-ventilator synchrony. New developments have been introduced aiming to improve patient ventilator synchrony by modulating the triggering function and the variables that control the flow delivery and the cycling off.


CONCLUSIONS
Patient-ventilator dyssynchrony may affect patients' outcome. New modes of assisted mechanical ventilation have been introduced and represent a major step forward in modulating patient-ventilator dyssynchrony.
Kondili
Eumorfia
E
Intensive Care Medicine Department, University Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece. konde@med.uoc.gr
Xirouchaki
Nektaria
N
Georgopoulos
Dimitris
D
D003422:Critical Care / Q000379:methods*; D006801:Humans; D011175:Positive-Pressure Respiration; D012123:Pulmonary Ventilation / Q000502:physiology*; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000295:instrumentation; D012131:Respiratory Insufficiency / Q000628:therapy*; D015656:Respiratory Mechanics; D013990:Tidal Volume; D013997:Time Factors; D016896:Treatment Outcome