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 Technologies

IntelliSync®+. Keeping an eye on patient-ventilator synchrony

Human eye that captures and processes digital data

How to detect asynchronies? A digital eye

The well-trained eye of a ventilation expert is capable of detecting asynchronies by analyzing the shapes of the flow and pressure waveforms.

However, the patient’s condition can change from breath to breath and the expert cannot always be at the bedside.

That is where IntelliSync+ takes over. This technology mimics the expert‘s eye to identify signs of patient effort (trigger) or relaxation (cycling) on the waveform.

InelliSync before and after

How does it work? IntelliSync+ principles

IntelliSync+ continuously analyzes waveform signals at least one hundred times per second. This enables IntelliSync+ to detect patient efforts immediately and to initiate inspiration and expiration in real time, thus replacing conventional trigger settings for inspiration and expiration.

For maximum flexibility, you can choose to activate IntelliSync+ for either the inspiratory trigger or the expiratory trigger, or both.

Graphical illustration: patient dossier with loupe

Are asynchronies really an issue? A look at the evidence

A high number of major patient-ventilator asynchronies occur in around 25% of all mechanically ventilated patients (Thille AW, Rodriguez P, Cabello B, Lellouche F, Brochard L. Patient-ventilator asynchrony during assisted mechanical ventilation. Intensive Care Med. 2006;32(10):1515-1522. doi:10.1007/s00134-006-0301-81​). They are associated with increased work of breathing (Tassaux D, Gainnier M, Battisti A, Jolliet P. Impact of expiratory trigger setting on delayed cycling and inspiratory muscle workload. Am J Respir Crit Care Med. 2005;172(10):1283-1289. doi:10.1164/rccm.200407-880OC2​), prolonged ventilation time (Thille AW, Rodriguez P, Cabello B, Lellouche F, Brochard L. Patient-ventilator asynchrony during assisted mechanical ventilation. Intensive Care Med. 2006;32(10):1515-1522. doi:10.1007/s00134-006-0301-81​), and higher mortality (Blanch L, Villagra A, Sales B, et al. Asynchronies during mechanical ventilation are associated with mortality. Intensive Care Med. 2015;41(4):633-641. doi:10.1007/s00134-015-3692-63​).

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 F, Iotti GA, Torriglia F, et al. In vivo calibration of esophageal pressure in the mechanically ventilated patient makes measurements reliable. Crit Care. 2016;20:98. Published 2016 Apr 11. doi:10.1186/s13054-016-1278-54​).

Ventilator Dispaly Ventilator Dispaly

How do you use it? IntelliSync+ setup and operation

IntelliSync+ is a completely noninvasive method that does not require any additional hardware or accessories. You just activate the option on your ventilator to use it in invasive and noninvasive ventilation modes on adult and pediatric patients.

As IntelliSync+ can also be combined with conventional triggers, you can choose to use IntelliSync+ either during inspiration or expiration, or both.

Graphic illustration: student holding certificate in her hand

Good to know! IntelliSync+ training resources

Asynchronies reference card

Learn to spot common asynchronies! Free reference card

Our asynchrony reference card gives you an overview of the most common asynchrony types, their causes, and how to detect them.

Availability

IntelliSync+ is available as an option on the HAMILTON-C6 and HAMILTON-G5, and is a standard feature on the HAMILTON-S1.

For more information

Document
IntelliSync+ brochure
English | 1 MB | 689602.00
Document
Asynchronies bibliography
English | 0.67 MB | ELO20190906S.00
Document
How to improve patient-ventilator synchrony whitepaper
English | 5.75 MB | ELO20171207S.00

Patient-ventilator asynchrony during assisted mechanical ventilation.

Authors: Arnaud W Thille, Pablo Rodriguez, Belen Cabello, François Lellouche, Laurent Brochard

Impact of expiratory trigger setting on delayed cycling and inspiratory muscle workload.

Authors: Didier Tassaux, Marc Gainnier, Anne Battisti, Philippe Jolliet

Asynchronies during mechanical ventilation are associated with mortality.

Authors: Lluís Blanch, Ana Villagra, Bernat Sales, Jaume Montanya, Umberto Lucangelo, Manel Luján, Oscar García-Esquirol, Encarna Chacón, Anna Estruga, Joan C Oliva, Alberto Hernández-Abadia, Guillermo M Albaiceta, Enrique Fernández-Mondejar, Rafael Fernández, Josefina Lopez-Aguilar, Jesús Villar, Gastón Murias, Robert M Kacmarek

In vivo calibration of esophageal pressure in the mechanically ventilated patient makes measurements reliable.

Authors: Francesco Mojoli, Giorgio Antonio Iotti, Francesca Torriglia, Marco Pozzi, Carlo Alberto Volta, Stefania Bianzina, Antonio Braschi, Laurent Brochard