ORIGINAL ARTICLE
Year : 2018  |  Volume : 12  |  Issue : 1  |  Page : 41-48

The effect of triggering type on post-triggering pressure variations during pressure support ventilation: a simplified surrogate for dyssynchrony


1 Department of Adult Cardiac Surgery, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia
2 Department of Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt

Correspondence Address:
Tamer S Fahmy
Department of Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, 11734
Egypt
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1687-8426.223061

Rights and Permissions

Context Several studies comparing flow and pressure triggering using invasive and noninvasive techniques have mostly focused on the trigger phase and favored flow triggering. Recently, there have been advancements in the technology of pressure triggering to improve its performance. Aims We sought to evaluate the effect of triggering type in old and new ventilators on patient’s synchrony in the post-trigger phase using variations in airway pressures with the set inspiratory pressure as a surrogate for dyssynchrony. Patients and methods Using three different ventilator types, 32 patients on pressure support ventilation were set on the two triggering types (at the same equivalent levels), each for 1 h, with all other ventilatory setting kept constant. At the end of the hour on each trigger mode, the measured peak pressure and its difference with the set inspiratory pressure [delta pressure (ΔP)], the mean airway pressure, and different ventilatory parameters and arterial blood gases were assessed. Results Pressure triggering resulted in a significantly higher peak pressure, ΔP, and lower dynamic compliance at any equivalent sensitivity and pressure support regardless of the level (<0.05). Moreover, at higher sensitivity levels (3 cmH2O and l/min), flow triggering produced higher mean airway pressures and oxygenation (<0.05). However, there was no significant difference as regards tidal volume, minute volume, frequency, rapid shallow breathing index, or PCO2. Conclusion Despite advances in pressure-triggering technology, flow triggering results in less pressure variation and better patient’s synchrony during pressure support ventilation; in this respect, ΔP and dynamic compliance are simple noninvasive measures for dyssynchrony.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1699    
    Printed64    
    Emailed0    
    PDF Downloaded110    
    Comments [Add]    

Recommend this journal