Asynchrony: Clinical Relevance, Detection, and Resolution
Bibliographic record
Abstract
Patient–ventilator asynchrony is defined as a mismatch between the patient’s intrinsic timing of inspiratory and expiratory efforts and the ventilator’s insufflation and exhalation, reflecting a discrepancy between the patient’s needs and the support delivered by the ventilator. Although asynchrony is frequently observed in mechanically ventilated patients, it remains unclear whether patient–ventilator asynchrony directly contributes to adverse outcomes, under what conditions some degree of asynchrony may be tolerated or beneficial, and how this knowledge should guide clinical management. The relationship between asynchronies and clinical outcomes is complex, influenced by multiple factors that may act as mechanisms of harm or benefit. These include the timing of asynchrony ( ie, during inspiration or expiration), the magnitude of patient effort, ventilator mode or settings, and patient-specific factors such as lung compliance. Importantly, patient–ventilator asynchrony can also serve as a marker of a patient’s underlying clinical condition, offering insight into the patient’s respiratory drive. Some forms of asynchrony are associated with high respiratory drive, whereas others occur in the context of low drive or overassistance. This review outlines the underlying mechanisms and clinical implications of patient–ventilator asynchronies. It also offers practical strategies for bedside detection and management and highlights future directions to improve recognition and resolution of patient–ventilator asynchrony in clinical practice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".