Reverse Triggered Breath during Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist at Increasing Propofol Infusion
Background: Reverse triggered breath (RTB) has been extensively described during assisted-controlled modes of ventilation. We aimed to assess whether RTB occurs during Pressure Support Ventilation (PSV) and Neurally Adjusted Ventilatory Assist (NAVA) at varying depths of propofol sedation. Methods:...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/14/4857 |
| _version_ | 1797588755942473728 |
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| author | Federico Longhini Rachele Simonte Rosanna Vaschetto Paolo Navalesi Gianmaria Cammarota |
| author_facet | Federico Longhini Rachele Simonte Rosanna Vaschetto Paolo Navalesi Gianmaria Cammarota |
| author_sort | Federico Longhini |
| collection | DOAJ |
| description | Background: Reverse triggered breath (RTB) has been extensively described during assisted-controlled modes of ventilation. We aimed to assess whether RTB occurs during Pressure Support Ventilation (PSV) and Neurally Adjusted Ventilatory Assist (NAVA) at varying depths of propofol sedation. Methods: This is a retrospective analysis of a prospective crossover randomized controlled trial conducted in an Intensive Care Unit (ICU) of a university hospital. Fourteen intubated patients for acute respiratory failure received six trials of 25 minutes randomly applying PSV and NAVA at three different propofol infusions: awake, light, and deep sedation. We assessed the occurrence of RTBs at each protocol step. The incidence level of RTBs was determined through the RTB index, which was calculated by dividing RTBs by the total number of breaths triggered and not triggered. Results: RTBs occurred during both PSV and NAVA. The RTB index was greater during PSV than during NAVA at mild (1.5 [0.0; 5.3]% vs. 0.6 [0.0; 1.1]%) and deep (5.9 [0.7; 9.0]% vs. 1.7 [0.9; 3.5]%) sedation. Conclusions: RTB occurs in patients undergoing assisted mechanical ventilation. The level of propofol sedation and the mode of ventilation may influence the incidence of RTBs. |
| first_indexed | 2024-03-11T00:57:36Z |
| format | Article |
| id | doaj.art-443359c620ef4c70ab918d73c0c80a54 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T00:57:36Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-443359c620ef4c70ab918d73c0c80a542023-11-18T19:55:00ZengMDPI AGJournal of Clinical Medicine2077-03832023-07-011214485710.3390/jcm12144857Reverse Triggered Breath during Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist at Increasing Propofol InfusionFederico Longhini0Rachele Simonte1Rosanna Vaschetto2Paolo Navalesi3Gianmaria Cammarota4Anesthesia and Intensive Care, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, ItalyDivision of Anesthesia, Analgesia and Intensive Care, Department of Medicine and Surgery, Hospital S. Maria della Misericordia, University of Perugia, 06123 Perugia, ItalyAnesthesia and Intensive Care, Department of Translational Medicine, Eastern Piedmont University, 28100 Novara, ItalyAnesthesia and Intensive Care, Padua Hospital, Department of Medicine—DIMED, University of Padua, 35128 Padova, ItalyAnesthesia and Intensive Care, Department of Translational Medicine, Eastern Piedmont University, 28100 Novara, ItalyBackground: Reverse triggered breath (RTB) has been extensively described during assisted-controlled modes of ventilation. We aimed to assess whether RTB occurs during Pressure Support Ventilation (PSV) and Neurally Adjusted Ventilatory Assist (NAVA) at varying depths of propofol sedation. Methods: This is a retrospective analysis of a prospective crossover randomized controlled trial conducted in an Intensive Care Unit (ICU) of a university hospital. Fourteen intubated patients for acute respiratory failure received six trials of 25 minutes randomly applying PSV and NAVA at three different propofol infusions: awake, light, and deep sedation. We assessed the occurrence of RTBs at each protocol step. The incidence level of RTBs was determined through the RTB index, which was calculated by dividing RTBs by the total number of breaths triggered and not triggered. Results: RTBs occurred during both PSV and NAVA. The RTB index was greater during PSV than during NAVA at mild (1.5 [0.0; 5.3]% vs. 0.6 [0.0; 1.1]%) and deep (5.9 [0.7; 9.0]% vs. 1.7 [0.9; 3.5]%) sedation. Conclusions: RTB occurs in patients undergoing assisted mechanical ventilation. The level of propofol sedation and the mode of ventilation may influence the incidence of RTBs.https://www.mdpi.com/2077-0383/12/14/4857pressure support ventilationneurally adjusted ventilatory assistpropofolpatient-ventilator asynchronysedationreverse triggered breath |
| spellingShingle | Federico Longhini Rachele Simonte Rosanna Vaschetto Paolo Navalesi Gianmaria Cammarota Reverse Triggered Breath during Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist at Increasing Propofol Infusion Journal of Clinical Medicine pressure support ventilation neurally adjusted ventilatory assist propofol patient-ventilator asynchrony sedation reverse triggered breath |
| title | Reverse Triggered Breath during Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist at Increasing Propofol Infusion |
| title_full | Reverse Triggered Breath during Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist at Increasing Propofol Infusion |
| title_fullStr | Reverse Triggered Breath during Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist at Increasing Propofol Infusion |
| title_full_unstemmed | Reverse Triggered Breath during Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist at Increasing Propofol Infusion |
| title_short | Reverse Triggered Breath during Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist at Increasing Propofol Infusion |
| title_sort | reverse triggered breath during pressure support ventilation and neurally adjusted ventilatory assist at increasing propofol infusion |
| topic | pressure support ventilation neurally adjusted ventilatory assist propofol patient-ventilator asynchrony sedation reverse triggered breath |
| url | https://www.mdpi.com/2077-0383/12/14/4857 |
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