Prevalence of Ventilatory Dyssynchrony in Critically Ill Patients

Background: Patient-ventilator Dyssynchrony is a common challenge in mechanically ventilated Intensive care unit patients, where mismatches occur between a patient's respiratory efforts and ventilator-delivered breaths. These dyssynchronies can lead to adverse outcomes, including increased respiratory effort, impaired gas exchange, prolonged ventilation, and higher mortality rates. Despite advancements in ventilator technology, patient-ventilator dyssynchrony still needs to be explored in specific clinical settings for over one year. Aim of the study: the study aimed to evaluate Patient-Ventilator Dyssynchrony prevalence, types, causes, and outcomes among Ghazi Al-Hariri Teaching Hospital, Iraq Intensive care unit patients. Methods: A prospective cohort study was conducted between October 1, 2023, and October 1, 2024, including 296 patients admitted to the Intensive care unit who met the inclusion criteria. Data were collected on patient demographics, clinical characteristics, ventilator settings, and outcomes using continuous monitoring and ventilator waveform analysis. Statistical analysis included Chi-square tests and student t-tests, with significance set at p < 0.05. Results: out of the 296 intensive care unit patients, 185 (62.5%) experienced patient-ventilator dyssynchrony. The mean age of Patient-Ventilator Dyssynchrony patients was 52.6 ± 19.2 years, and 54% were male. Trigger dyssynchrony was the most prevalent type (62.7%), followed by flow dyssynchrony (27%) and cycle dyssynchrony (10.3%). The most frequent cause was Insufficient tidal volume, and Insufficient inspiratory time was reported in 70 out of 185 patients (37.8%), followed by Insufficient flow reported in 50 out of 185 patients (27%). Pressure support assist mode was the most frequently associated ventilator mode (77.8%). Conclusion: Patient-ventilator dyssynchrony is a significant concern in Intensive care unit environments, impacting more than 50% of patients on mechanical ventilation and leading to major clinical issues. The most frequent and dangerous type is trigger dyssynchrony, highlighting the necessity for optimized ventilator settings and continuous monitoring to improve synchronization.