DOI: https://doi.org/10.22263/2312-4156.2025.2.63
V.A. Dudko1,2, T.I. Doroshkova1, A.L. Lipnitski1,2, A.V. Marochkov1,2, V.A. Livinskaya3
Integrative anxiety index as an objective criterion for effective synchronization of mechanical ventilation
1Mogilev Regional Clinical Hospital, Mogilev, Republic of Belarus
2Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
3Belarusian-Russian University, Mogilev, Republic of Belarus
Vestnik VGMU. 2025;24(2):63-70.
Abstract.
Objectives. To analyze the episodes of interaction between mechanical ventilation and spontaneous breathing of a patient based on the indicators of the respirator alarm signal and to develop an integrative alarm indicator for the quantitative assessment of the desynchronization degree.
Material and methods. In this work, 242 episodes of prolonged mechanical ventilation were analyzed in 44 patients with ARDS (acute respiratory distress syndrome) of various etiologies and varying degrees of severity. To assess quantitatively the desynchronization degree, we developed an integrative alarm indicator (IAI), which is the sum of the episodes of the ventilator alarm signal triggering when the set alarm limits of the following parameters are exceeded: peak inspiratory pressure (Ppеак), ventilation frequency (f), minute ventilation volume (MV) and tidal volume (Vt) per unit of time - 1 hour.
Results. Significant differences were obtained between the IAI groups in the following parameters: minute ventilation volume (MV), tidal volume (Vt), frequency (Ftotal), partial pressure of CO2 in the exhaled mixture (etCO2), volume of formed CO2 (VCO2), Compliance (Compl), Trigger (Trigger). The IAI groups differed significantly in the depth of sedation using fentanyl, in the level of sedation determined by EEG monitoring and the Ramsay scale.
Conclusions. The integrative anxiety index is a criterion independent of other anxiety indices, characterizing the degree of optimal compliance between the respiratory cycles of the ventilator and the patient’s spontaneous breathing.
Keywords: artificial lung ventilation, synchronization, desynchronization, drug sedation, “apparatus-patient” system, quantitative assessment.
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Submitted 06.12.2024
Accepted 14.04.2025
Information about authors:
V.A. Dudko – Head of the Anesthesiology and Resuscitation Department of the Cardiovascular Surgery Center of the Mogilev Regional Clinical Hospital, Senior Lecturer of the Branch of the Departments of Anesthesiology and Resuscitation with the Course of Advanced Training and Continuing Education and Hospital Surgery with the Course of Advanced Training and Continuing Education of the Vitebsk State Order of Friendship of Peoples Medical University, https://orcid.org/0000-0002-5959-5454
T.I. Doroshkova – Anesthesiologist Resuscitator of the Anesthesiology and Resuscitation Department of the Cardiovascular Surgery Center of the Mogilev Regional Clinical Hospital, https://orcid.org/0000-0002-4426-0213
Artur L. Lipnitski – Candidate of Medical Sciences, head of the department for coordination of taking organs and tissues for transplantation, Mogilev Regional Clinical Hospital; associate professor of the affiliated branch of the Chairs of Anesthesiology and Resuscitation with the course of the Faculty for Advanced Training & Retraining and Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-2556-4801, e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра.;
A.V. Marochkov – Doctor of Medical Sciences, professor, anesthesiologist-resuscitator of the anesthesiology and resuscitation department, Mogilev Regional Clinical Hospital; professor of the branch of the Chairs of Anesthesiology & Resuscitation and Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0001-5092-8315
V.A. Livinskaya – Candidate of Physical and Mathematical Sciences, associate professor of the Chair «Finance &Accounting», Belarusian-Russian University, https://orcid.org/0000-0001-8953-8533
