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The effects of real-time waveform analysis software on patient ventilator synchronization during pressure support

Barnpot Nakornnoi¹, Jamsak Tscheikuna¹, Nuttapol Rittayamai²

¹Division of Respiratory Diseases and Tuberculosis, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

BMC Pulmonary Medicine

|May 1, 2024

Summary

IntelliSync+ software improved inspiratory trigger delay time in patients on pressure support ventilation (PSV). However, this new ventilation technology did not significantly enhance cycle delay or other physiological variables.

Area of Science:

Mechanical Ventilation
Respiratory Physiology
Critical Care Medicine

Background:

Patient-ventilator asynchrony is a common issue during pressure support ventilation (PSV).
IntelliSync+ is a novel ventilation technology designed to detect patient inspiration in real time by analyzing ventilator waveforms.
Understanding the physiological impact of IntelliSync+ is crucial for optimizing ventilation strategies.

Purpose of the Study:

To evaluate the physiological effects of IntelliSync+ software during PSV.
To assess changes in inspiratory trigger delay time.
To measure pressure drops and hemodynamic variables associated with IntelliSync+.

Main Methods:

A randomized crossover study involving 14 mechanically ventilated patients on PSV.
Patients were exposed to conventional flow trigger, inspiratory trigger synchronization (I-sync), cycle synchronization (C-sync), and combined synchronization (I/C-sync) for 15-minute intervals.
Key physiological parameters including airway (Paw) and esophageal (Pes) pressures, airflow, P0.1, SpO2, and hemodynamics were recorded.

Main Results:

IntelliSync+ significantly reduced inspiratory trigger delay time with I-sync and I/C-sync compared to baseline.
The I/C-sync mode demonstrated significantly lower delta Paw and Pes drops during the trigger phase compared to C-sync.
No significant differences were observed in cycle delay time or other measured physiological variables across the different synchronization modes.

Conclusions:

IntelliSync+ software effectively reduces inspiratory trigger delay time compared to conventional flow triggers in PSV.
While inspiratory triggering is improved, IntelliSync+ did not show significant benefits in cycle delay time or other physiological outcomes.
Further research may explore optimizing IntelliSync+ settings for broader clinical benefits.

Keywords:

Asynchrony Esophageal pressure Patient-ventilator interaction Pressure support ventilation

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