Patient ventilator asynchrony is a common problem in mechanically ventilated patients .It is associated with adverse effects including increased work of breathing, patient discomfort, increased need for sedation, prolonged mechanical ventilation , weaning difficulties and weaning failure. 100 mechanically ventilated COPD patients were enrolled in this prospective study .Detection of patient ventilator asynchrony was done on 30-minute sessions at 12, 24, 36, and 48 hours following intubation by visual assessment of pressure, flow and volume graphs on ventilator .

Patient-ventilator asynchrony is defined as a lack of organization between the patient and ventilator timing of both inspiration and expiration . It is a commonly reported problem during mechanical ventilation. Thille et al. found that 24% of patients developed asynchrony in at least ten percent of their breaths, moreover they stated that the most frequent asynchronies was each of ineffective triggering and double triggering . Eighty percent of chronic obstructive pulmonary disease (COPD) patients experienced ineffective triggering, where it is considered the most frequent asynchrony in this group of patients. Asynchrony between Patient and ventilator also leads to prolonged duration of invasive ventilation, and increase possibility of weaning failure.

Both spread and intensity of asynchrony during the early phase of weaning in COPD patients has never satisfactorily described. The aim of the current study was to describe the patient-ventilator asynchrony and its impact on weaning outcome in mechanically ventilated COPD patients.

Inclusion Criteria:

All COPD patients who were diagnosed after history ,physical examination radiology and pulmonary function tests and required mechanical ventilation.

Exclusion Criteria:

1. Age < 18 years

2. Tracheostomy

3. Failure to trigger breaths even in cases of receiving neuromuscular blocking agents.

4. Encephalopathy which is not caused by hypercapnia or hypoxemia either post arrest or due to cerebrovascular stroke

5. Patients with unplanned weaning

6. COPD patients where intubation not related to exacerbation e.g. acute pulmonary edema.

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All COPD patients who were diagnosed after history ,physical examination ,radiology and pulmonary function tests and required mechanical ventilation.