double triggering is when patient initiates both breaths
- related: basic modes of ventilators
- tags: #literature #icu
- patient initiates both breaths
- compare this with reverse triggering is when patient initiates 2nd breath
- this often also has flow desynchrony
Ventilator graphics including pressure vs time (top), flow vs time (middle), and volume vs time (bottom) that demonstrate flow asynchrony (arrows) and double trigger (bar) asynchronies.
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reverse triggering is when patient initiates 2nd breath
- Reverse triggering is a form of patient-ventilator interaction in which respiratory muscle contraction occurs after the onset of a passive mandatory breath. It is thought that the passive mechanical thoracic insufflation triggers a patient-initiated breath as a reflex action. In cases such as the one illustrated here, this respiratory muscle activity is strong enough to trigger a second stacked or double cycled breath. This form of breath stacking differs from classical double trigger asynchronies, in which both paired breaths are initiated by the patient (double triggering is when patient initiates both breaths). Reverse triggering was initially observed in deeply sedated patients and has been seen in brain-dead patients. Newer data suggest reverse triggering is more common than originally thought.[^1][^2][^3][^4][^5][^6]