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• W2047403453 abstract "With current ventilator triggering design, in initiating ventilator breaths patient effort is only a small fraction of the total effort expended to overcome the inspiratory load. Similarly, advances in ventilator pressure or flow delivery and inspiratory flow termination improve patient effort or inspiratory muscle work during mechanical ventilation. Yet refinements in ventilator design do not necessarily allow optimal patient-ventilator interactions, as the clinician is key in managing patient factors and selecting appropriate ventilator factors to maintain patient-ventilator synchrony. In patient-ventilator interactions, unmatched patient flow demand by ventilator flow delivery results in flow asynchrony, whereas mismatches between mechanical inspiratory time (mechanical T_I) and neural T_I produce timing asynchrony. Wasted efforts are an example of timing asynchrony. In the triggering phase, trigger thresholds that are set too high or the type of triggering methods induces wasted efforts. Wasted efforts can be aggravated by respiratory muscle weakness or other conditions that reduce respiratory drive. In the post-triggering phase, ventilator factors play an important role in patient-ventilator interaction; this role includes the assistance level, set inspiratory flow rate, T_I, pressurization rate, and cycling-off threshold, and to some extent, applied PEEP. This paper proposes an algorithm that clinicians can use to adjust ventilator settings with the goal to eliminate or reduce patients9 wasted efforts." @default.
• W2047403453 created "2016-06-24" @default.
• W2047403453 creator A5025707210 @default.
• W2047403453 date "2011-01-01" @default.
• W2047403453 modified "2023-10-14" @default.
• W2047403453 title "Triggering of the Ventilator in Patient-Ventilator Interactions" @default.
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• W2047403453 doi "https://doi.org/10.4187/respcare.01006" @default.
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