Which of the following can be adversely affected by poor patient-ventilator interaction? 1. Gas exchange 2. Ventilatory patterns 3. Hemodynamics 4. Length of mechanical ventilation
a. 1 and 3 only
b. 1, 2, and 3 only
c. 2 and 4 only
d. 1, 2, 3, and 4
ANS: D
At minimum hemodynamics, ventilatory pattern and gas exchange are adversely affected. Recent data indicates that asynchrony occurs in ALL patients receiving assisted patient-triggered venti-lation, is most significant during the morning when clinician patient interaction is greatest, is pre-sent even during period of sedation, and varies from mild to very severe asynchrony7. What is most important to remember is that asynchrony has been associated with increased length of me-chanical ventilation, ICU and hospital length of stay, the need for tracheostomy, and ICU and hospital mortality.
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