Bedside diagnosis of bilateral diaphragmatic paralysis

Liet, Jean-Michel; Dejode, Jean-Marc; Joram, Nicolas; Roux, Bénédicte Gaillard Le; Péreón, Yann

doi:10.1007/s00134-012-2729-3

Cited by 6 publications

(2 citation statements)

References 4 publications

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“…This low respiratory activity has previously been reported [ 14 , 32 ]. It could be the consequence of overassistance, oversedation, their combination, or more rarely of an abnormal output by the central respiratory center or by bilateral phrenic nerve palsy [ 33 , 34 ]. In this study group, many patients were admitted for nonrespiratory reasons.…”

Section: Discussionmentioning

confidence: 99%

Patient–ventilator asynchrony during conventional mechanical ventilation in children

Mortamet

Larouche

Ducharme‐Crevier

et al. 2017

Ann. Intensive Care

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BackgroundWe aimed (1) to describe the characteristics of patient–ventilator asynchrony in a population of critically ill children, (2) to describe the risk factors associated with patient–ventilator asynchrony, and (3) to evaluate the association between patient–ventilator asynchrony and ventilator-free days at day 28.MethodsIn this single-center prospective study, consecutive children admitted to the PICU and mechanically ventilated for at least 24 h were included. Patient–ventilator asynchrony was analyzed by comparing the ventilator pressure curve and the electrical activity of the diaphragm (Edi) signal with (1) a manual analysis and (2) using a standardized fully automated method.ResultsFifty-two patients (median age 6 months) were included in the analysis. Eighteen patients had a very low ventilatory drive (i.e., peak Edi < 2 µV on average), which prevented the calculation of patient–ventilator asynchrony. Children spent 27% (interquartile 22–39%) of the time in conflict with the ventilator. Cycling-off errors and trigger delays contributed to most of this asynchronous time. The automatic algorithm provided a NeuroSync index of 45%, confirming the high prevalence of asynchrony. No association between the severity of asynchrony and ventilator-free days at day 28 or any other clinical secondary outcomes was observed, but the proportion of children with good synchrony was very low.ConclusionPatient–ventilator interaction is poor in children supported by conventional ventilation, with a high frequency of depressed ventilatory drive and a large proportion of time spent in asynchrony. The clinical benefit of strategies to improve patient–ventilator interactions should be evaluated in pediatric critical care.

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Section: Discussionmentioning

confidence: 99%

Patient–ventilator asynchrony during conventional mechanical ventilation in children

Mortamet

Larouche

Ducharme‐Crevier

et al. 2017

Ann. Intensive Care

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“…The clinical use of EAdi can be divided into either the direct ventilatory application, that is, NAVA, or as a sensitive detector of breathing activity 40 in diseases, such as congenital central hypoventilation syndrome, 41,42 postoperatively after diaphragmatic hernia, 43 phrenic nerve injury after cardiac surgery 44 etc.…”

Section: Neurally Adjusted Ventilatory Assistmentioning

confidence: 99%

Proportional assist and neurally adjusted ventilation: Clinical knowledge and future trials in newborn infants

Sindelar

McKinney

Wallström

et al. 2021

Pediatric Pulmonology

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Different types of patient triggered ventilator modes have become the mainstay of ventilation in term and preterm newborn infants. Maintaining spontaneous breathing has allowed for earlier weaning and the additive effects of respiratory efforts combined with pre‐set mechanical inflations have reduced mean airway pressures, both of which are important components in trying to avoid lung injury and promote normal lung development. New sophisticated modes of assisted ventilation have been developed during the last decades where the control of ventilator support is turned over to the patient. The ventilator detects the respiratory effort and adjusts ventilatory assistance proportionally to each phase of the respiratory cycle, thus enabling the patient to have full control of the start, the duration and the amount of ventilatory assistance. In this paper we will review the literature on the ventilatory modes of proportional assist ventilation and neurally adjusted ventilatory assistance, examine the different ways the signals are analyzed, propose future studies, and suggest ways to apply these modes in the clinical environment.

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Incidence, risk factors and 90-day mortality of patients with acute kidney injury in Finnish intensive care units: the FINNAKI study

et al. 2013

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Bedside diagnosis of bilateral diaphragmatic paralysis

Cited by 6 publications

References 4 publications

Patient–ventilator asynchrony during conventional mechanical ventilation in children

Patient–ventilator asynchrony during conventional mechanical ventilation in children

Proportional assist and neurally adjusted ventilation: Clinical knowledge and future trials in newborn infants

Incidence, risk factors and 90-day mortality of patients with acute kidney injury in Finnish intensive care units: the FINNAKI study

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