RT Journal Article
SR Electronic
T1 Prevalence of patient-ventilator asynchronies and effects on sleep quality in neuromuscular patients using long term non-invasive ventilation
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p2087
VO 38
IS Suppl 55
A1 Grazia Crescimanno
A1 Maria Canino
A1 Oreste Marrone
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p2087.abstract
AB Background: There are few studies on the association between asynchronies and arousals in patients using long term noninvasive ventilation (NIV) and among them, only one has been performed on neuromuscular patients. Moreover, in the real life of home ventilated neuromuscular patients sleep fragmentation is probably far from being perfectly corrected.Objective: The aim of this work was to investigate the prevalence of patient-ventilator asynchronies and their association with sleep quality in stable neuromuscular patients chronically ventilated after optimization of ventilator setting.Methods: Eighteen patients were included in the study. Sleep was recorded during ventilator application using standard polysomnography. Physiologic tracings were scored for autotriggerings, patient-ventilator desynchronizations, prolonged insufflations (PI) and respiratory arousals.Results: Most frequent asynchronies were autotriggerings and desynchronizations (83.33% and 77.77% of patients, median/h 1.11 (IQR 0.43-2.84) and 0.23 (IQR 0.12-1.00) respectively). Desynchronization was the asynchrony most frequently associated with arousal (median 73.61%, IQR 15.91-96.88) followed by autotriggering (median 60%, IQR 0-90.9). PI was not frequent and almost never associated with arousal (median 0 IQR 0-100). Asynchronies were significantly correlated with leaks (r=0.49 p= 0.035).Conclusion: Patient-ventilator asynchronies may still occur in neuromuscular patients receiving home long term NIV and can contribute to sleep fragmentation. Monitoring of quality of ventilation should be included in long term programme of neuromuscular patients.