Related Experiment Video
Updated: Mar 25, 2026
Inspiratory Muscle Training as an Adjunct to the Treatment of Weaning Failure in Critically Ill Patients: A Practical Guide
Published on: January 30, 2026
Patient-Ventilator Asynchrony During Assisted Ventilation in Children
Robert G T Blokpoel1, Johannes G M Burgerhof, Dick G Markhorst
11Department of Paediatrics, Division of Paediatric Intensive Care, Beatrix Children's Hospital, University Medical Center Groningen, The University of Groningen, Groningen, The Netherlands. 2Department of Epidemiology, University Medical Center Groningen, The University of Groningen, Groningen, The Netherlands. 3Department of Paediatrics, Division of Paediatric Intensive Care, VU University Medical Center, Amsterdam, The Netherlands. 4Critical Care, Anesthesia, Peri-operative Medicine and Emergency Medicine (CAPE), The University of Groningen, Groningen, The Netherlands.
Patient-ventilator asynchrony is common in children on mechanical ventilation, occurring in one-third of breaths. Ineffective triggering is the most frequent type, highlighting a key area for improving respiratory support.
Area of Science:
- Pediatric Critical Care Medicine
- Respiratory Physiology
- Biomedical Engineering
Background:
- Mechanical ventilation is crucial for critically ill children.
- Patient-ventilator asynchrony (PVA) can negatively impact outcomes.
- Understanding PVA in pediatric populations is essential.
Purpose of the Study:
- To determine the frequency and types of PVA in mechanically ventilated children.
- To analyze ventilator flow and pressure signals for asynchrony detection.
- To identify factors associated with PVA in this cohort.
Main Methods:
- Prospective observational study in a tertiary pediatric intensive care unit (PICU).
- Analysis of ventilator flow and pressure signals from 45 children (0-18 years).
- Categorization of PVA into trigger, flow, termination, and expiratory asynchronies.
Main Results:
- PVA occurred in 33% of analyzed breaths across all patients.
- Ineffective triggering was the most common type (68% of PVA).
- PVA increased with lower peak inspiratory pressure, PEEP, and set respiratory rate.
Conclusions:
- Patient-ventilator asynchrony is highly prevalent in pediatric mechanical ventilation.
- Ineffective triggering is the primary driver of PVA in this population.
- Optimizing ventilator settings may reduce PVA and improve patient outcomes.
Related Concept Videos
01:14Ventilatory Modes
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
01:23Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
01:29Mechanical Ventilation I: Indication and Settings
01:23Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:29Assessment of Ventilation II: Respiratory Depth and Rhythm
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement: