Keeping an eye on patient-ventilator synchrony
The well-trained eye of a ventilation expert is capable of detecting asynchronies by analyzing the waveform shapes of either the flow or the pressure waveforms. However, the expert cannot always be at the bedside, and the patient condition can change from breath to breath.
That is where IntelliSync+ takes over. This new technology mimics the expert‘s eye to identify signs of patient effort (trigger) or relaxation (cycling), thus replacing conventional trigger settings for inspiration and expiration.
How IntelliSync+ works
The new IntelliSync+ technology mimics the expert‘s eye by continuously analyzing waveform shapes at least hundred times per second. This allows IntelliSync+ to detect patient efforts immediately, and to initiate inspiration and expiration in real-time.
For maximum flexibility, IntelliSync+ can be activated to automate either the inspiratory trigger or the expiratory trigger, or both.
How to use IntelliSync+
In this video, we will show you how to use IntelliSync+ on the HAMILTON-G5 to improve patient- ventilator synchronization.
The video shows you how to activate IntelliSync+ to replace either the inspiratory trigger setting (for flow or pressure trigger), the expiratory trigger sensitivity setting, or both. It is demonstrated on the HAMILTON-G5 and works the same way on the HAMILTON-S1.
Significant patient-ventilator asynchronies occur in more than 25% of all mechanically ventilated patients (Thille 2006), and are associated with increased work of breathing (Tassaux 2005), prolonged ventilation time (Thille 2016), and higher mortality (Blanch 2015).
Analyzing waveform shapes is a reliable, accurate, and reproducible method for assessing patient-ventilator interaction. Automation of this method may allow continuous monitoring of ventilated patients and/or improved breath triggering and cycling (Mojoli 2016).
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How to improve patient-ventilator synchrony
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Tassaux D, Gainnier M, Battisti A, Jolliet P. Impact of Expiratory Trigger Setting on Delayed Cycling and Inspiratory Muscle Workload. American Journal of Respiratory and Critical Care Medicine. 2005;172(10):1283-1289.
Thille A, Rodriguez P, Cabello B, Lellouche F, Brochard L. Patient-ventilator asynchrony during assisted mechanical ventilation. Intensive Care Medicine. 2006;32(10):1515-1522.
Blanch L, Villagra A, Sales B, Montanya J, Lucangelo U, Luján M et al. Asynchronies during mechanical ventilation are associated with mortality. Intensive Care Medicine. 2015;41(4):633-641.
Mojoli F, Iotti G, Arnal J, Braschi A. Is the ventilator switching from inspiration to expiration at the right time? Look at waveforms!. Intensive Care Medicine. 2015;42(5):914-915.