• Priya Prabhakaran, William C Sasser, Yuvrai Kalra, Chrystal Rutledge, and Nancy M Tofil.
• Section of Critical Care, Department of Pediatrics, University of Alabama, Birmingham, AL, USA - pprabhakaran@peds.uab.edu.
• Minerva Pediatr. 2016 Dec 1; 68 (6): 456-469.

AbstractProviding optimal mechanical ventilation to critically-ill children remains a challenge. Patient-ventilator dyssynchrony results frequently with numerous deleterious consequences on patient outcome including increased requirement for sedation, prolonged duration of ventilation, and greater imposed work of breathing. Most currently used ventilators have real-time, continuously-displayed graphics of pressure, volume, and flow versus time (scalars) as well as pressure, and flow versus volume (loops). A clear understanding of these graphics provides a lot of information about the mechanics of the respiratory system and the patient ventilator interaction in a dynamic fashion. Using this information will facilitate tailoring the support provided and the manner in which it is provided to best suit the dynamic needs of the patient. This paper starts with a description of the scalars and loops followed by a discussion of the information that can be obtained from each of these graphics. A review will follow, on the common types of dyssynchronous interactions and how each of these can be detected on the ventilator graphics. The final section discusses how graphics can be used to optimize the ventilator support provided to patients.

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