Respiratory failure & ventilation
Double cycling with breath-stacking during partial support ventilation in ARDS: Just a feature of natural variability?
Authors' conclusion
DC/BS events during partial ventilatory support were infrequent and linked to breathing variability. Their frequency and physiological effects on lung compliance and EELI resemble spontaneous sighs and may not be considered a priori as harmful.
Study context
- Population
- Hypoxemic (ARDS) patients resuming spontaneous breathing under partial ventilatory supportcrossover
- Participants
- 20 participants
- Comparison
- Neurally adjusted ventilatory assist (NAVA) vs PAV+ vs pressure support ventilation (PSV)
- Primary endpoint
- Incidence of double cycling with breath-stacking (DC/BS: two inspiratory cycles with incomplete exhalation)
Primary result
As reported in the abstract
DC/BS incidence
P = 0.06
Further findings
Mechanism of DC/BS
- Single inspiratory effort
- 42%
- Two apparent consecutive inspiratory efforts
- 58%
Association with breathing variability
- DC/BS associated with coefficient of variability for tidal volume
- P = 0.014
- DC/BS associated with coefficient of variability for respiratory rate
- P = 0.011
DC/BS breaths vs regular breaths
- Higher tidal volume, muscular pressure and regional stretch in DC/BS breaths
Post-DC/BS cycles
- No evidence of expiratory muscle activation
- 63%
- Frequently improved end-expiratory lung impedance (EELI) and CLdyn
Original publication
Double cycling with breath-stacking during partial support ventilation in ARDS: Just a feature of natural variability? Crit Care. Published 10 January 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →