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Introduction: Patient ventilator asynchrony is a common problem in mechanically ventilated (MV) patients .It is associated with adverse effects including increased work of breathing, patient discomfort,Increased need for sedation, prolonged mechanical ventilation , weaning difficulties and weaning failure. Objectives: To describe patient ventilator asynchrony and its impact on weaning outcome in MV COPD patients. Methodology: 100 MV COPD patients were enrolled in this prospective study .Detection of patient ventilator asynchrony was done on 30-minute sessions at 12, 24, 36, and 48 hours following intubation through ventilator graphs .Asynchrony index (A.I) is calculated for events in each session by dividing number of total asynchronies by the total respiratory rate (ventilator cycle + wasted effort) × 100. Ineffective trigger index (ITI) is calculated in the same way.Average values for A.I and ITI are obtained from indices calculated in the four sessions. Results: Weaning failure (need of NIV or reintubation with in 48 hr of extubation) was noticed in 27 (27%) patients while 73 (73%) patients had successful weaning. Patients with failed weaning had significantly higher asynchrony index (A.I) and ineffective trigger index (ITI) in comparison to those with successful weaning (7.69 ± 3.71) , (3.46 ± 2.59) versus (6.27 ± 3.14) ,(2.47 ± 2.08) respectively (P value Conclusion: Patient ventilator asynchrony is a common problem in mechanically ventilated COPD patients. High asynchrony index and ineffective trigger index may be early predictors of weaning failure in those patients. |
