• BlokpoelRobert G TRGTDepartment of Paediatrics, Division of Paediatric Intensive Care, Beatrix Children's Hospital, University Medical Center Groningen, The University of Groningen, Groningen, the Netherlands., BurgerhofJohannes G MJGMDepartment of Epidemiology, University Medical Center Groningen, The University of Groningen, Groningen, the Netherlands., Dick G Markhorst, and KneyberMartin C JMCJDepartment of Paediatrics, Division of Paediatric Intensive Care, Beatrix Children's Hospital, University Medical Center Groningen, The University of Groningen, Groningen, the Netherlands.Department of Paediatrics, Division of Paediatr.
• Department of Paediatrics, Division of Paediatric Intensive Care, Beatrix Children's Hospital, University Medical Center Groningen, The University of Groningen, Groningen, the Netherlands.
• Pediatr Crit Care Me. 2021 Nov 1; 22 (11): 993-997.

ObjectivesTo explore the level and time course of patient-ventilator asynchrony in mechanically ventilated children and the effects on duration of mechanical ventilation, PICU stay, and Comfort Behavior Score as indicator for patient comfort.DesignSecondary analysis of physiology data from mechanically ventilated children.SettingMixed medical-surgical tertiary PICU in a university hospital.PatientsMechanically ventilated children 0-18 years old were eligible for inclusion. Excluded were patients who were unable to initiate and maintain spontaneous breathing from any cause.Measurements And Main ResultsTwenty-nine patients were studied with a total duration of 109 days. Twenty-two study days (20%) were excluded because patients were on neuromuscular blockade or high-frequency oscillatory ventilation, yielding 87 days (80%) for analysis. Patient-ventilator asynchrony was detected through analysis of daily recorded ventilator airway pressure, flow, and volume versus time scalars. Approximately one of every three breaths was asynchronous. The percentage of asynchronous breaths significantly increased over time, with the highest prevalence on the day of extubation. There was no correlation with the Comfort Behavior score. The percentage of asynchronous breaths during the first 24 hours was inversely correlated with the duration of mechanical ventilation. Patients with severe patient-ventilator asynchrony (asynchrony index > 10% or > 75th percentile of the calculated asynchrony index) did not have a prolonged duration of ventilation.ConclusionsThe level of patient-ventilator asynchrony increased over time was not related to patient discomfort and inversely related to the duration of mechanical ventilation.Copyright © 2021 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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