Classification of Patient-Ventilator Asynchrony: Development of an Updated Conceptual Framework: Scoping Review

Objective: This scoping review seeks to fulfill two objectives: to evaluate the current literature on existing classifications of asynchrony and to propose a new classification (Adjustable, Innovative, and Applicable in any ICU) with theoretical validity and consistency based on the literature and expert judgment, useful for the development of new research projects.Introduction: Patient-ventilator asynchrony (PVA) has an 85% prevalence in invasive mechanical ventilation (IMV) with high underdiagnosis, associated with increased mortality, complications, and prolonged ventilation and ICU stays. Multiple classifications are subject to questionable comprehensiveness, subject to clinical judgment and visual review, and lack clinical validation or sufficient replicability for use in daily practice.Inclusion criteria: Patients in ICUs receiving invasive mechanical ventilation will be selected from scientific literature that includes definitions, compares, or validates PAP classifications, from any country, with no language or year of publication restrictions. NIMV studies, isolated reports without a proposed classification, case series, editorials without data, or pregnant patients will be excluded.Methods: Scoping review according to the Joanna Briggs Institute (JBI®) methodology, with research conducted in the following databases: PUBMED/MEDLINE, Scopus, EMBASE, Web of Science, and Cochrane Library; also useful articles that increase sensitivity, and gray literature such as Google Scholar, OpenGrey, NTIS, and EAGLE from the journal's inception until August 1, 2025, with no language restrictions. Titles and abstracts of potentially eligible studies will be reviewed, followed by the full texts by two independent reviewers. Keywords: Patient ventilator Asynchrony, Dyssynchrony, Classification, Mechanical ventilation, Critical care.