ok, let's talk about asynchrony. we can have two different asynchrony types. one is a timing asynchrony and one is flow assist asynchrony. the timing asynchrony happens when the ventilator overcomes the neuroventilatory inspiratory time of the patient. and the flow asynchrony is something like a lack of proportionality in the adequacy of assistance. now we can try to record if with high pressure support level we can see some asynchrony with this patient. let's wait a second and then let's look at the edi signal. and let's see if we can see something on the edi curve.
ok. recording. of course asynchrony is much more evident with a higher level of pressure support. and asynchrony means morbidity increase, longer stay on ventilator, longer stay on icu, a hugerisk of ventilator associated pneumonia, so we have to avoid asynchrony in the ventilatory assistance of our patient. example of flow assist asynchrony: low edi but higher pressure support level. and an example of timing asynchrony: the starting of the ventilator is not the start of neural inspiration bythe patient and the cycling of ventilator is good, but the triggering is not good enough. and then an example of autotriggering:
no trigger from the patient, but triggerfrom the ventilator. and this is another one: no trigger from the patient trigger from the ventilator, autotriggering.
this one is an example of a small diaphragm activity but timing asynchrony again. autotrigging again. flow assist asynchrony is small, not a huge delay in opening the valve, but a small effort from the diaphragm and triggering the ventilator.
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