Reverse Trigger in Ventilated Non-ARDS Patients: A Phenomenon Can Not Be Ignored!
IntroductionThe role of reverse trigger (RT) was unknown in ventilated non-acute respiratory distress syndrome (ARDS) patients. So we conducted a retrospective study to evaluate the incidence, characteristics and physiologic consequence of RT in such population.MethodSix ventilated non-ARDS patients...
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Frontiers Media S.A.
2021-07-01
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| author | Zhimin Lin Zhimin Lin Zhimin Lin Jing Zhou Jing Zhou Jing Zhou Xiaoling Lin Xiaoling Lin Xiaoling Lin Yingzhi Wang Yingzhi Wang Yingzhi Wang Haichong Zheng Haichong Zheng Haichong Zheng Weixiang Huang Weixiang Huang Weixiang Huang Xiaoqing Liu Xiaoqing Liu Xiaoqing Liu Yimin Li Yimin Li Yimin Li Nanshan Zhong Nanshan Zhong Nanshan Zhong Yongbo Huang Yongbo Huang Yongbo Huang Yuanda Xu Yuanda Xu Yuanda Xu Ling Sang Ling Sang Ling Sang Ling Sang |
| author_facet | Zhimin Lin Zhimin Lin Zhimin Lin Jing Zhou Jing Zhou Jing Zhou Xiaoling Lin Xiaoling Lin Xiaoling Lin Yingzhi Wang Yingzhi Wang Yingzhi Wang Haichong Zheng Haichong Zheng Haichong Zheng Weixiang Huang Weixiang Huang Weixiang Huang Xiaoqing Liu Xiaoqing Liu Xiaoqing Liu Yimin Li Yimin Li Yimin Li Nanshan Zhong Nanshan Zhong Nanshan Zhong Yongbo Huang Yongbo Huang Yongbo Huang Yuanda Xu Yuanda Xu Yuanda Xu Ling Sang Ling Sang Ling Sang Ling Sang |
| author_sort | Zhimin Lin |
| collection | DOAJ |
| description | IntroductionThe role of reverse trigger (RT) was unknown in ventilated non-acute respiratory distress syndrome (ARDS) patients. So we conducted a retrospective study to evaluate the incidence, characteristics and physiologic consequence of RT in such population.MethodSix ventilated non-ARDS patients were included, the esophageal balloon catheter were placed for measurements of respiratory mechanics in all patients. And the data were analyzed to identified the occurrence of RT, duration of the entrainment, the entrainment pattern or ratio, the phase difference (dP) and the phase angle (θ), phenotypes, Effects and clinical correlations of RT.ResultRT was detected in four patients of our series (66.7%), and the occurrence of RT varying from 19 to 88.6% of their recording time in these 4 patients. One patient (No.2) showed a stable 1:1 ratio and Mid-cycle RT was the most common phenotype. However, the remained patients showed a mixed ratios, and Late RT was the most common phenotype, followed by RT with breath stacking. The average values of mean phase delay and phase angles were 0.39s (0.32, 0.98) and 60.52° (49.66, 102.24). Mean phase delay and phase angles were shorter in early reverse triggering with early and delayed relaxation, and longer in mid, late RT and RT with breath stacking. Pmus was variable between patients and phenotypes, and larger Pmus was generated in Early RT, Delayed Relaxation and mid cycle RT. When the RT occurred, the Peso increased 17.27 (4.91, 19.71) cmH2O compared to the controlled breathing, and the average value of incremental ΔPeso varied widely inter and intra patients (Table 3B and Figure 1). Larger ΔPeso was always generated in Early RT, Delayed Relaxation and mid cycle RT, accompanied by an significant increase of PL with 19.12 (0.75) cmH2O and 16.10 (6.23) cmH2O.ConclusionRT could also be observed in ventilated non-ARDS patients. The characteristics of pattern and phenotype was similar to RT in ARDS patients to a large extent. And RT appeared to alter lung stress and delivered volumes. |
| first_indexed | 2024-12-13T20:48:50Z |
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| series | Frontiers in Physiology |
| spelling | doaj.art-ddfcce848a6b485d81344506e4980c432022-12-21T23:31:55ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2021-07-011210.3389/fphys.2021.670172670172Reverse Trigger in Ventilated Non-ARDS Patients: A Phenomenon Can Not Be Ignored!Zhimin Lin0Zhimin Lin1Zhimin Lin2Jing Zhou3Jing Zhou4Jing Zhou5Xiaoling Lin6Xiaoling Lin7Xiaoling Lin8Yingzhi Wang9Yingzhi Wang10Yingzhi Wang11Haichong Zheng12Haichong Zheng13Haichong Zheng14Weixiang Huang15Weixiang Huang16Weixiang Huang17Xiaoqing Liu18Xiaoqing Liu19Xiaoqing Liu20Yimin Li21Yimin Li22Yimin Li23Nanshan Zhong24Nanshan Zhong25Nanshan Zhong26Yongbo Huang27Yongbo Huang28Yongbo Huang29Yuanda Xu30Yuanda Xu31Yuanda Xu32Ling Sang33Ling Sang34Ling Sang35Ling Sang36Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaGuangzhou Institute of Respiratory Health, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, Guangzhou, ChinaDepartment of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaGuangzhou Institute of Respiratory Health, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, Guangzhou, ChinaDepartment of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaGuangzhou Institute of Respiratory Health, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, Guangzhou, ChinaDepartment of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaGuangzhou Institute of Respiratory Health, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, Guangzhou, ChinaDepartment of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaGuangzhou Institute of Respiratory Health, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, Guangzhou, ChinaDepartment of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaGuangzhou Institute of Respiratory Health, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, Guangzhou, ChinaDepartment of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaGuangzhou Institute of Respiratory Health, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, Guangzhou, ChinaDepartment of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaGuangzhou Institute of Respiratory Health, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, Guangzhou, ChinaDepartment of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaGuangzhou Institute of Respiratory Health, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, Guangzhou, ChinaDepartment of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaGuangzhou Institute of Respiratory Health, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, Guangzhou, ChinaDepartment of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaGuangzhou Institute of Respiratory Health, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, Guangzhou, ChinaDepartment of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaGuangzhou Institute of Respiratory Health, Guangzhou, ChinaState Key Laboratory of Respiratory Disease, Guangzhou, ChinaGuangzhou Laboratory, Guangzhou, ChinaIntroductionThe role of reverse trigger (RT) was unknown in ventilated non-acute respiratory distress syndrome (ARDS) patients. So we conducted a retrospective study to evaluate the incidence, characteristics and physiologic consequence of RT in such population.MethodSix ventilated non-ARDS patients were included, the esophageal balloon catheter were placed for measurements of respiratory mechanics in all patients. And the data were analyzed to identified the occurrence of RT, duration of the entrainment, the entrainment pattern or ratio, the phase difference (dP) and the phase angle (θ), phenotypes, Effects and clinical correlations of RT.ResultRT was detected in four patients of our series (66.7%), and the occurrence of RT varying from 19 to 88.6% of their recording time in these 4 patients. One patient (No.2) showed a stable 1:1 ratio and Mid-cycle RT was the most common phenotype. However, the remained patients showed a mixed ratios, and Late RT was the most common phenotype, followed by RT with breath stacking. The average values of mean phase delay and phase angles were 0.39s (0.32, 0.98) and 60.52° (49.66, 102.24). Mean phase delay and phase angles were shorter in early reverse triggering with early and delayed relaxation, and longer in mid, late RT and RT with breath stacking. Pmus was variable between patients and phenotypes, and larger Pmus was generated in Early RT, Delayed Relaxation and mid cycle RT. When the RT occurred, the Peso increased 17.27 (4.91, 19.71) cmH2O compared to the controlled breathing, and the average value of incremental ΔPeso varied widely inter and intra patients (Table 3B and Figure 1). Larger ΔPeso was always generated in Early RT, Delayed Relaxation and mid cycle RT, accompanied by an significant increase of PL with 19.12 (0.75) cmH2O and 16.10 (6.23) cmH2O.ConclusionRT could also be observed in ventilated non-ARDS patients. The characteristics of pattern and phenotype was similar to RT in ARDS patients to a large extent. And RT appeared to alter lung stress and delivered volumes.https://www.frontiersin.org/articles/10.3389/fphys.2021.670172/fullreverse triggeringmechanical ventilationsedationacute respiratory distress syndromerespiratory mechanics |
| spellingShingle | Zhimin Lin Zhimin Lin Zhimin Lin Jing Zhou Jing Zhou Jing Zhou Xiaoling Lin Xiaoling Lin Xiaoling Lin Yingzhi Wang Yingzhi Wang Yingzhi Wang Haichong Zheng Haichong Zheng Haichong Zheng Weixiang Huang Weixiang Huang Weixiang Huang Xiaoqing Liu Xiaoqing Liu Xiaoqing Liu Yimin Li Yimin Li Yimin Li Nanshan Zhong Nanshan Zhong Nanshan Zhong Yongbo Huang Yongbo Huang Yongbo Huang Yuanda Xu Yuanda Xu Yuanda Xu Ling Sang Ling Sang Ling Sang Ling Sang Reverse Trigger in Ventilated Non-ARDS Patients: A Phenomenon Can Not Be Ignored! Frontiers in Physiology reverse triggering mechanical ventilation sedation acute respiratory distress syndrome respiratory mechanics |
| title | Reverse Trigger in Ventilated Non-ARDS Patients: A Phenomenon Can Not Be Ignored! |
| title_full | Reverse Trigger in Ventilated Non-ARDS Patients: A Phenomenon Can Not Be Ignored! |
| title_fullStr | Reverse Trigger in Ventilated Non-ARDS Patients: A Phenomenon Can Not Be Ignored! |
| title_full_unstemmed | Reverse Trigger in Ventilated Non-ARDS Patients: A Phenomenon Can Not Be Ignored! |
| title_short | Reverse Trigger in Ventilated Non-ARDS Patients: A Phenomenon Can Not Be Ignored! |
| title_sort | reverse trigger in ventilated non ards patients a phenomenon can not be ignored |
| topic | reverse triggering mechanical ventilation sedation acute respiratory distress syndrome respiratory mechanics |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2021.670172/full |
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