title: Patient-Ventilator Interactions.
abstract: Ventilatory muscle fatigue is a reversible loss of the ability to generate force or velocity of contraction in response to increased elastic and resistive loads. Mechanical ventilation should provide support without imposing additional loads from the ventilator (dys-synchrony). Interactive breaths optimize this relationship but require that patient effort and the ventilator response be synchronous during breath initiation, flow delivery, and termination. Proper delivery considers all 3 phases and uses clinical data, ventilator graphics, and sometimes a trial-and-error approach to optimize patient-ventilator interactions. Newer modes optimize interactions but await good clinical outcome data before routine use.
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Duke University Medical Center, Box 102355, Hanes House Room 101, Durham, NC 27710, USA. Electronic address: daniel.gilstrap@dm.duke.edu.
authors.forename: Daniel
authors.initials: D
authors.lastname: Gilstrap
authors.affiliation: Respiratory Care Services, Duke University Hospital, Box 3911 Duke North, Erwin Road, Durham, NC 27710, USA.
authors.forename: John
authors.initials: J
authors.lastname: Davies
mesh_terms: D006801:Humans; D010361:Patients; D012121:Respiration, Artificial / Q000379:methods*
keywords: Interactive ventilator modes; Neutrally adjusted ventilatory assist; Patient-ventilator interactions; Proportional assist ventilation; Ventilator dys-synchrony