Expiratory Muscle Relaxation-Induced Ventilator Triggering: A Novel Patient-Ventilator Dyssynchrony.
expiratory muscles
mechanical ventilation
patient-ventilator dyssynchrony
Journal
Chest
ISSN: 1931-3543
Titre abrégé: Chest
Pays: United States
ID NLM: 0231335
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
received:
26
01
2022
accepted:
28
01
2022
entrez:
9
6
2022
pubmed:
10
6
2022
medline:
14
6
2022
Statut:
ppublish
Résumé
In critically ill patients receiving mechanical ventilation, expiratory muscles are recruited with high respiratory loading and/or low inspiratory muscle capacity. In this case report, we describe a previously unrecognized patient-ventilator dyssynchrony characterized by ventilator triggering by expiratory muscle relaxation, an observation that we termed expiratory muscle relaxation-induced ventilator triggering (ERIT). ERIT can be recognized with in-depth respiratory muscle monitoring as (1) an increase in gastric pressure (Pga) during expiration, resulting from expiratory muscle recruitment; (2) a drop in Pga (and hence, esophageal pressure) at the time of ventilator triggering; and (3) diaphragm electrical activity onset occurring after ventilator triggering. Future studies should focus on the incidence of ERIT and the impact in the patient receiving mechanical ventilation.
Identifiants
pubmed: 35680312
pii: S0012-3692(22)00281-1
doi: 10.1016/j.chest.2022.01.070
pmc: PMC9248081
pii:
doi:
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
e337-e341Informations de copyright
Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.
Références
Anesthesiology. 2021 May 1;134(5):748-759
pubmed: 33711154
J Appl Physiol (1985). 2020 Aug 1;129(2):366-376
pubmed: 32673161
Chest. 2013 Apr;143(4):927-938
pubmed: 23187649
Anesthesiology. 2018 Sep;129(3):490-501
pubmed: 29771711
Intensive Care Med. 2020 Apr;46(4):594-605
pubmed: 31938825
J Appl Physiol (1985). 2007 Jul;103(1):140-7
pubmed: 17395760
Intensive Care Med. 2019 Aug;45(8):1061-1071
pubmed: 31236639