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Author de Wit, Marjolein ♦ Pedram, Sammy ♦ Best, Al M. ♦ Epstein, Scott K.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Philosophy & psychology ♦ Psychology ♦ Natural sciences & mathematics ♦ Life sciences; biology ♦ Physiology & related subjects ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Human physiology ♦ Incidence & prevention of disease ♦ Pharmacology and therapeutics ♦ Diseases ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Respiratory Tract Diseases ♦ Diseases ♦ Diagnosis ♦ Therapeutics ♦ Anesthesia and Analgesia ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Psychological Phenomena and Processes ♦ Psychiatry and Psychology ♦ Physical Phenomena ♦ Circulatory and Respiratory Physiological Phenomena ♦ Biological Sciences ♦ Persons ♦ Persons ♦ Geographic Locations ♦ Geographic Locations
Subject Keyword Discipline Critical Care ♦ Conscious Sedation ♦ Adverse Effects ♦ Respiration, Artificial ♦ Respiratory Mechanics ♦ Physiology ♦ Aged ♦ Analysis Of Variance ♦ Methods ♦ Critical Care ♦ Drug Monitoring ♦ Equipment Failure ♦ Female ♦ Humans ♦ Male ♦ Middle Aged ♦ Monitoring, Physiologic ♦ Pilot Projects ♦ Pulmonary Disease, Chronic Obstructive ♦ Physiopathology ♦ Therapy ♦ Instrumentation ♦ Respiratory Insufficiency ♦ Metabolism ♦ Risk Factors ♦ Sample Size ♦ Time Factors ♦ Virginia ♦ Wakefulness ♦ Drug Effects ♦ Journal Article ♦ Research Support, N.i.h., Extramural
Abstract PURPOSE: Clinicians frequently administer sedation to facilitate mechanical ventilation. The purpose of this study was to examine the relationship between sedation level and patient-ventilator asynchrony. MATERIALS AND METHODS: Airway pressure and airflow were recorded for 15 minutes. Patient-ventilator asynchrony was assessed by determining the number of breaths demonstrating ineffective triggering, double triggering, short cycling, and prolonged cycling. Ineffective triggering index (ITI) was calculated by dividing the number of ineffectively triggered breaths by the total number of breaths (triggered and ineffectively triggered). Sedation level was assessed by the following 3 methods: Richmond Agitation-Sedation Scale (RASS), awake (yes or no), and delirium (Confusion Assessment Method for the intensive care unit [CAM-ICU]). RESULTS: Twenty medical ICU patients underwent 35 observations. Ineffective triggering was seen in 17 of 20 patients and was the most frequent asynchrony (88% of all asynchronous breaths), being observed in 9% +/- 12% of breaths. Deeper levels of sedation were associated with increasing ITI (awake, yes 2% vs no 11%; P < .05; CAM-ICU, coma [15%] vs delirium [5%] vs no delirium [2%]; P < .05; RASS, 0, 0% vs -5, 15%; P < .05). Diagnosis of chronic obstructive pulmonary disease, sedative type or dose, mechanical ventilation mode, and trigger method had no effect on ITI. CONCLUSIONS: Asynchrony is common, and deeper sedation level is a predictor of ineffective triggering.
Spatial Coverage Virginia
Description Country affiliation: United States
Author Affiliation: de Wit M ( Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Box 980050, Richmond, VA 23298-0050, USA.)
ISSN 08839441
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2009-03-01
Publisher Place United States
e-ISSN 15578615
Journal Journal of Critical Care
Volume Number 24
Issue Number 1


Source: WHO-Global Index Medicus