Patient-ventilator synchrony under non-invasive ventilation is improved by an automated real time waveform analysis...

Area of Science:

• Respiratory Mechanics
• Mechanical Ventilation
• Biomedical Engineering

Background:

• Patient-ventilator asynchrony is a challenge in non-invasive ventilation (NIV) due to inherent leaks.
• IntelliSync+ software analyzes airway curves to detect breathing transitions and improve synchrony.

Purpose of the Study:

• Evaluate the impact of IntelliSync+ on synchrony during NIV with simulated leaks (9 and 20 L/min).
• Assess performance across normal, obstructive, and restrictive respiratory mechanics at different pressure support levels (PS 8 and 14 cmH2O).

Main Methods:

• Bench study using a ventilator circuit without a face mask.
• Measured time to trigger (Td) and expiratory termination (Tiex).
• Assessed classical asynchronies and ventilator pressurization capacity.

Main Results:

• IntelliSync+ improved expiratory termination (Tiex) and, to a lesser extent, inspiratory trigger time (Td) compared to classical NIV mode.
• A trend towards reduced asynchronies was observed, particularly after sudden leak increases.
• Improvements were most significant with high PS levels and pathological respiratory mechanics (obstructive and restrictive).

Conclusions:

• IntelliSync+ enhances both expiratory and inspiratory synchrony in NIV with leaks.
• The system demonstrates particular efficacy in obstructive/restrictive models and high-pressure support scenarios.
• Pre-clinical data support IntelliSync+'s potential to improve NIV patient-ventilator synchrony and warrant clinical evaluation.