Patient–ventilator asynchrony is common in severe pneumonia and can worsen outcomes if not identified and corrected early. In routine practice, PVA is often assessed through brief bedside observations, making detection subjective and intermittent. A new digital platform now enables continuous, real-time monitoring of ventilator waveforms, allowing precise quantification of asynchrony throughout the entire course of mechanical ventilation.

The “Remote Ventilate View” platform, developed by researchers at Peking Union Medical College Hospital (Beijing, China), automatically analyzes ventilator waveforms in real time, identifies eight distinct PVA subtypes, and calculates the overall asynchrony index. This approach shifts PVA assessment from qualitative spot checks to objective, longitudinal measurement.

The researchers applied the platform to patients with COVID-19–associated severe pneumonia receiving mechanical ventilation. Continuous waveform data were analyzed to quantify overall and subtype-specific asynchrony across the ventilation period. Patient outcomes were then correlated with the calculated overall asynchrony index to assess its prognostic value.

The study demonstrated a clear association between high overall asynchrony burden and poor outcomes. Patients with an overall asynchrony index of 10% or higher had significantly higher intensive care unit mortality and markedly fewer ventilator-free days at 28 days compared with those below this threshold. Among individual subtypes, flow insufficiency was independently associated with prognosis, highlighting a specific and potentially modifiable contributor to adverse outcomes.

The findings, published in the Journal of Intensive Medicine, suggest that continuous digital monitoring of PVA can support more precise and personalized ventilator management. The overall asynchrony index may serve as an early warning indicator, prompting clinicians to address factors such as sedation depth, respiratory drive, or ventilator settings. Beyond COVID-19, the platform has broad potential application in other mechanically ventilated patients, including those with ARDS from different causes.

“This study successfully integrates digital technology with clinical needs, demonstrating the feasibility of real-time PVA monitoring and its significant prognostic value in mechanically ventilated COVID-19 patients,” said Yun Long, MD, corresponding author of the study.

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