Respiratory failure & ventilation
Post-insufflation diaphragm contractions in patients receiving various modes of mechanical ventilation
Authors' conclusion
In critically ill mechanically ventilated patients, PIDCs and reverse triggering phenotypes were associated with potentially modifiable factors, including ventilator settings.
Study context
- Population
- Mechanically ventilated patients with hypoxemic respiratory failure183,962 breaths
- Participants
- 47 participants
- Exposure
- Breath types and ventilation modes
- Outcome
- Post-insufflation diaphragm contractions (PIDCs) and their association with ventilator settings and patients' characteristics
Methodological detailsbreath-by-breath analysis, multivariable logistic regression, 1-h recordings of EAdi, airway pressure and flow once daily for up to 5 days
- Breath-by-breath analysis
- Multivariable logistic regression
- 1-h recordings of EAdi, airway pressure and flow once daily for up to 5 days
Main finding
As reported in the abstract
PIDCs by breath type
Odds ratio (95% CI)P value
Higher EAdi peak
1.01(1.01–1.01)
P ≤ 0.008Longer Tineuro
37.59(34.50–40.98)
P ≤ 0.008Shorter ventilator inspiratory time
0.27(0.24–0.30)
P ≤ 0.008High peak inspiratory flow
0.22(0.20–0.26)
P ≤ 0.008Small tidal volumes
0.31(0.25–0.37)
P ≤ 0.008NAVAassociated with absence of PIDCs
0.03(0.02–0.03)
P < 0.001Observational data: associations, not effects.
Further findings
Reverse triggering characteristics
- Lower EAdi peak than pressure support triggered breaths; associated with small tidal volume and shorter set inspiratory time than assist-control triggered breaths (all P < 0.05)
Reverse triggering leading to breath stacking
- Higher peak EAdi, longer Tineuro and associated with small tidal volumes vs all other reverse-triggering phenotypes (all P < 0.05)
Original publication
Post-insufflation diaphragm contractions in patients receiving various modes of mechanical ventilation. Crit Care. Published 18 September 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →