Respiratory failure & ventilation
Flow-Limited and Reverse-Triggered Ventilator Dyssynchrony Are Associated With Increased Tidal and Dynamic Transpulmonary Pressure*
Authors' conclusion
Double-triggered, flow-limited, early reverse-triggered, and early ventilator-terminated breaths are associated with increases in V t , ΔP L,dyn , and energy.
Study context
- Population
- Medical ICU patients with acute respiratory distress syndrome (ARDS) or ARDS risk factorsover 580,000 breaths
- Participants
- 35 patients
- Exposure
- Ten breath types vs each other
Methodological detailscontinuous esophageal manometry, machine learning detection of dyssynchrony, mixed-effect models
- Continuous esophageal manometry
- Machine learning detection of dyssynchrony
- Mixed-effect models
Main finding
As reported in the abstract
- Double-triggered breaths associated with the most significant increase in Vt, ΔP L,dyn and transpulmonary mechanical energy
- Flow-limited, early reverse-triggered and early ventilator-terminated breaths also associated with significant increases in Vt, ΔP L,dyn and energy
- Potential of a dyssynchrony type to increase Vt, ΔP L,dyn or energy clustered similarly
Observational data: associations, not effects.
Further findings
Effect modification by set Vt, positive end-expiratory pressure (PEEP) and sedation (RASS)
- Increasing set Vt may be associated with a disproportionate increase in high-volume and high-energy ventilation from double-triggered breaths
- PEEP and sedation do not clinically modify the interaction between dyssynchrony and surrogate markers of lung stress and strain
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Flow-Limited and Reverse-Triggered Ventilator Dyssynchrony Are Associated With Increased Tidal and Dynamic Transpulmonary Pressure*. Crit Care Med. Published 12 January 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →