Ability to identify patient-ventilator asynchronies in intensive care unit professionals: A multicenter cross-sectional analytical study

Andrés Mauricio Enríquez Popayán¹, Iván Ignacio Ramírez², Juan Felipe Zúñiga³, Ruvistay Gutierrez-Arias⁴, Mayda Alejandra Jiménez Pérez⁵, Henry Mauricio Parada-Gereda⁶, Luis Fernando Pardo Cocuy⁷, Ana Lucia Rangel Colmenares⁸, Nubia Castro Chaparro⁹, Ana Pinza Ortega¹⁰, Jorge Martínez Díaz¹¹, Johanna Hurtado Laverde¹², Joismer Alejandro Henao Cruz¹³

1 Departamento de Fisioterapia en Cuidado Intensivo, GyO Medical, Yopal, Colombia; Departamento de Fisioterapia en Cuidado Intensivo, Clínica SIMALINK, Yopal, Colombia
2 Departamento de Apoyo en Rehabilitación Cardiopulmonar Integral, Instituto Nacional del Tórax, Santiago, Chile; INTRehab Research Group, Instituto Nacional del Tórax, Santiago, Chile; Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad Diego Portales, Santiago, Chile
3 Departamento de Fisioterapia en Cuidado Intensivo, Clínica de Occidente, Cali, Colombia
4 Departamento de Apoyo en Rehabilitación Cardiopulmonar Integral, Instituto Nacional del Tórax, Santiago, Chile; INTRehab Research Group, Instituto Nacional del Tórax, Santiago, Chile; Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
5 Departamento de Fisioterapia en Cuidado Intensivo, Fundación Hospital San Pedro, Pasto, Colombia
6 Unidad de Cuidado Intensivo, Clínica Reina Sofia, Bogotá, Colombia; Clínica Colsanitas, Grupo de Investigación en Nutrición Clínica y Rehabilitación-Keralty, Bogotá, Colombia. ???Especialización de Fisioterapia en Paciente Adulto Critico, Universidad del Rosario, Bogotá, Colombia.
7 Departamento de Fisioterapia en Cuidado Intensivo, Hospital Universitario Mayor Méderi, Bogotá, Colombia; Especialización de Fisioterapia en Paciente Adulto Critico, Universidad del Rosario, Bogotá, Colombia.
8 Departamento de Fisioterapia en Cuidado Intensivo, Clínica Norte, Cúcuta, Colombia; Departamento de Fisioterapia en Cuidado Intensivo, Clínica San José, Cúcuta, Colombia
9 Departamento de Cuidado Intensivo, Lumira SAS, Cali, Colombia
10 Departamento de Fisioterapia en Cuidado Intensivo, Fundación Hospital San Pedro, Pasto, Colombia; Programa de Fisioterapia, Universidad Mariana, Pasto, Colombia; Grupo de Investigación en Medicina Critica GMC, Fundación Hospital San Pedro, Pasto, Colombia
11 Departamento de Cuidado Intensivo, Fundación Hospital San Pedro, Pasto, Colombia; Programa de Medicina, Fundación Universidad San Martin, Pasto, Colombia; Grupo de Investigación en Medicina Critica GMC, Fundación Hospital San Pedro, Pasto, Colombia
12 Programa de Terapia Respiratoria, Universidad Manuela Beltrán, Bogotá, Colombia
13 Departamento de Fisioterapia en Cuidado Intensivo, Hospital Universitario de Caldas, Manizales, Colombia

DOI: 10.2478/jccm-2025-0017

Introduction: Patient-ventilator asynchrony (PVA) is frequent in intensive care. Its presence is associated with prolonged days of mechanical ventilation and may lead to increased mortality in the intensive care unit (ICU) and hospital. Little is known about the ability of Colombian intensive care professionals to identify asynchronies, and the factors associated with their correct identification are not apparent.
Aim of the study: To describe the ability of Colombian intensive care professionals to identify patient-ventilator asynchronies (PVA) using waveform analysis. In addition, to define the characteristics associated with correctly detecting PVA.
Material and methods: We conducted a multicenter, cross-sectional, national survey-based study between January and August 2024. Colombian physiotherapists, respiratory therapists, nurses and intensive care physicians from 24 departments participated in the study. An online survey was used. They were asked to identify six different PVAs presented as videos. The videos were displayed using pressure/time and flow/time waveform of a Puritan Bennett 840 ventilator.
Results: We recruited 900 participants, 60% female, most of whom were physiotherapists (53%). Most professionals had specialty training in critical care (42%), and 32% reported having specific PVA training. Double triggering was the most frequently identified PVA (75%). However, only 3.67% of participants recognized all six PVAs. According to multiple logistic regression analysis, working in a mixed unit (OR 2.59; 95% CI 1.19 – 5.54), caring for neonates (OR 5.19; 95% CI 1.77 – 15.20), and having specific training (OR 2.38; 95% CI 1.16 – 4.76) increases the chance of correctly recognizing all PVAs.
Conclusion: In Colombia, a low percentage of professionals recognize all PVAs. Having specific training in this topic, working in mixed ICUs and neonatal intensive care was significantly associated with identifying all PVAs.