Name this Asynchrony 4
What is the most likely form of asynchrony causing this waveform?
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What is the most likely form of asynchrony causing this waveform?
Voting has ended, view the full write up on Reverse Triggering.
Podría tener alguna influencia el tipo de disparo escogido (flow or pressure) en el desarrollo o no de una “breath stacking” en el contexto de reverse triggering?
When the full article is posted you will see that the mode choice would not have made a difference whether breath stacking occurs unless an iTime of >2 seconds is used.
Lot’s of mess going on here. First, flow curve is zigzagging all over so I assume there is condensation in both inspiratory and expiratory hosing or/and endotracheal tube.
Second, we see the first breath occurring before total exhalation (flow doesn’t not return to zero). That could surely lead to overinflation, formation of autoPEEP and hence ineffective triggering seen right after the first breath.
Third delivered breath is triggered by “patient’s effort” (positive deflection in flow, negative in pressure), following mechanical breath so I suppose there’s a reverse triggering present.
Flow starvation. A longer inspiratory time will help.
It seems that diaphragm contractions are triggered by mandatory breaths. So, it is a reverse triggering.