{ "abstract": "Background: A recent study published by our group demonstrated that patient–ventilator asynchrony (PVA) is independently associated with impaired gas exchange during long-term non-invasive ventilation (NIV). We aimed to determine whether the burden and phenotype of residual PVA vary according to disease category, NIV initiation context and follow-up timing, and whether the relationship between PVA and gas exchange differs according to follow-up timing. Methods: We performed a secondary analysis of 123 NIV-treated patients included in the primary study. PVA burden, upper-airway obstructive events and leaks were compared across disease categories and follow-up settings. Multivariable models for gas exchange outcomes were extended by introducing interaction terms between PVA burden and follow-up category. Patients underwent either long-term follow-up performed >3 months after NIV initiation (n = 74), early acute follow-up, i.e., after stabilization following NIV initiation in acute respiratory failure (n = 30), or early planned follow-up, i.e., within 3 months after NIV initiation in stable chronic respiratory failure (CRF) (n = 19). Results: Overall, leaks, upper airway obstructions (UAOs) and PVA burden did not significantly differ across disease categories, and neither leaks nor UAO differed across follow-up categories. In contrast, patients undergoing early follow-up after acute NIV initiation exhibited a significantly greater burden of residual PVA than those initiated in stable CRF, predominantly because of ineffective efforts. Within the subgroup of patients undergoing early follow-up, total PVA burden was more than doubled after acute NIV initiation (4.5% versus 1.5% of recording time; 6.2 versus 2.5 events·h−1). The association between PVA burden and post-NIV PaCO2 did not differ according to follow-up timing. Conversely, in an exploratory analysis limited to 40 patients, the relationship between PVA burden and nocturnal TcPCO2 was significantly attenuated during early compared with long-term follow-up (interaction β = −1.04, 95% CI −1.68 to −0.40; p = 0.003). However, this interaction was attenuated after adjustment for daytime PaCO2 (β = −0.55, 95% CI −1.12 to 0.03; p = 0.076). Stratified analyses demonstrated significant associations between PVA burden and both post-NIV PaCO2 (β = 0.38, p = 0.034) and nocturnal TcPCO2 (β = 0.80, p < 0.001) during routine long-term follow-up. Conclusions: Patients evaluated after acute NIV initiation exhibited the highest burden of residual PVA, predominantly ineffective efforts. However, PVA was independently associated with nocturnal hypercapnia primarily during established long-term NIV. These findings should be considered hypothesis-generating and require confirmation in larger prospectively monitored cohorts.", "abstract_shown": true, "affiliations": [ "Department of Pulmonology, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France", "Research on Healthcare Performance (RESHAPE), INSERM U1290, University Claude Bernard Lyon 1, 69373 Lyon, France", "Hypoxie Physiopathologie (HP2), INSERM U1300, University Grenoble Alpes, 38058 Grenoble, France", "Institut Universitaire du Poumon, Centre de Référence Constitutif des Maladies Pulmonaires Rares de l’Adulte, Centre Hospitalo-Universitaire Dijon-Bourgogne, 21000 Dijon, France", "Faculty of Medicine and Pharmacy, University Bourgogne Europe, 21000 Dijon, France", "Centre des Sciences du Goût et de l’Alimentation, INRAE, UMR 6265 CNRS 1234, University Bourgogne Europe, 21000 Dijon, France", "Division of Pulmonary Medicine, Lausanne University Hospital (CHUV), University of Lausanne, CH-1011 Lausanne, Switzerland", "Center for Translational and Molecular Medicine (CTM), INSERM U1231, University Bourgogne Europe, 21000 Dijon, France" ], "article_type": "research article", "arxiv": null, "author_total": 8, "authors": [ { "affs": [ 0, 1, 2 ], "name": "Pierre Tankéré", "orcid": "0000-0002-3793-7126" }, { "affs": [ 3, 4, 5 ], "name": "Marjolaine Georges", "orcid": "0000-0002-4659-5076" }, { "affs": [ 3 ], "name": "Ameline Vagner" }, { "affs": [ 3 ], "name": "Jade Chorvoz" }, { "affs": [ 0 ], "name": "Geoffroy Mery" }, { "affs": [ 6 ], "name": "Cedric Bongard" }, { "affs": [ 3, 4, 7 ], "name": "Philippe Bonniaud", "orcid": "0000-0002-3670-5622" }, { "affs": [ 3, 6 ], "name": "Claudio Rabec" } ], "bibtex": "https://research.draconitic.com/paper/99akvkkrm0asg.bib", "cited_by": 0, "doi": "10.3390/jcm15197695", "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665768/?tool=EBI", "id": "99akvkkrm0asg", "issns": [ "2077-0383" ], "landing_url": "https://europepmc.org/article/PMC/PMC13665768", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "hal", "0.sdv" ], [ "hal", "1.sdv.mhep" ], [ "hal", "2.sdv.mhep.psr" ], [ "openalex", "2740|Respiratory Support and Mechanisms" ] ], "openalex": "W7220395882", "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665768/pdf/?tool=EBI", "pmcid": "PMC13665768", "pmid": "42882156", "published": "2026-10-01", "publisher": "MDPI", "ris": "https://research.draconitic.com/paper/99akvkkrm0asg.ris", "sources": [ { "first_seen": "2026-10-30T12:17:31Z", "native_id": "PMC:PMC13665768", "source": "europepmc", "url": "https://europepmc.org/article/PMC/PMC13665768" }, { "first_seen": "2026-10-30T12:18:02Z", "native_id": "hal-05842259", "source": "hal", "url": "https://hal.inrae.fr/hal-05842259v1" }, { "first_seen": "2026-10-30T12:20:00Z", "native_id": "10.3390/jcm15197695", "source": "crossref", "url": "https://www.mdpi.com/2077-0383/15/19/7695" } ], "subjects": [ { "field": "biology", "origin": "hal:0.sdv", "subfield": "general" }, { "field": "medicine", "origin": "hal:1.sdv.mhep", "subfield": "general" } ], "title": "Residual Sleep-Related Respiratory Events During Early Versus Long-Term NIV Follow-Up: Burden and Relationship with Gas Exchange", "title_text": "Residual Sleep-Related Respiratory Events During Early Versus Long-Term NIV Follow-Up: Burden and Relationship with Gas Exchange", "type": "peer-reviewed", "updated_at": "2026-10-30T12:20:00Z", "url": "https://research.draconitic.com/paper/99akvkkrm0asg", "venue": "Journal of clinical medicine", "versions": [] }