PATIENT-VENTILATOR ASYNCHRONY IN INTENSIVE CARE ENVIRONMENT: A NATIONAL STUDY

TYPE: Abstract Publication TOPIC: Critical Care PURPOSE: Ventilator waveforms analysis has been noninvasively and reliably used to detect patient-ventilator asynchrony (PVA), but using this tool hasn't been studied in Saudi Arabia. METHODS: An observational study was conducted using a validated evaluation tool to assess the ability of critical care professionals (CCPs) to detect different types of asynchrony presented in three videos. This tool consisted of three videos of common asynchronies (double-triggering, auto-triggering, and ineffective effort). The data was collected by an evaluation sheet that was distributed to 39 hospitals in Saudi Arabia among different CCPs, including respiratory therapists (RTs), nurses and physicians. RESULTS: A total of 411 CCPs were assessed. Only 41 (10.2 %) of these CCPs correctly identified the three types of asynchrony, while 25.3% did not recognize any asynchrony. There were statistically significant differences between trained and non-trained CCPs in recognizing (3 asynchronies, P <0.001; 2 asynchronies, P =0 .001), (table 1). Prior training on ventilator waveforms and female gender have all increased the odds to identify >2 asynchronies correctly with ORs (95% CIs) of 5.41 (3.26-8.98) and 1.93 (1.07-3.49) respectively. CONCLUSIONS: The detection of common PVAs in critical care settings in Saudi Arabia was low, with around 25% asynchronies were unrecognized by CCPs. Prior training on ventilator graphics and female gender were the only significant predictive factors for correctly identifying asynchronies using waveform analysis, independent of profession, experience, and hospital characteristics. CLINICAL IMPLICATIONS: There is an urgent need for establishing teaching and training programs, policies and guidelines on early detection and management of asynchronies to improve patients’ outcomes. DISCLOSURE: No significant relationships. KEYWORDS: Asynchrony, Mechanical Ventilator, CRITICAL CARE