Reverse triggering ? a novel or previously missed phenomenon?

dc.article.number78
dc.catalogadoryvc
dc.contributor.authorJackson, Robert
dc.contributor.authorKim, Audery
dc.contributor.authorMoroz, Nikolay
dc.contributor.authorDamiani Rebolledo, L. Felipe
dc.contributor.authorLuca Grieco, Domenico
dc.contributor.authorPiraino, Thomas
dc.contributor.authorFriedrich, Jan O.
dc.contributor.authorMercat, Alain
dc.contributor.authorTelias, Irene
dc.contributor.authorBrochard, Laurent J.
dc.date.accessioned2024-06-06T14:07:54Z
dc.date.available2024-06-06T14:07:54Z
dc.date.issued2024
dc.description.abstractBackground Reverse triggering (RT) was described in 2013 as a form of patient-ventilator asynchrony, where patient’s respiratory effort follows mechanical insufflation. Diagnosis requires esophageal pressure (Pes) or diaphragmatic electrical activity (EAdi), but RT can also be diagnosed using standard ventilator waveforms. Hypothesis We wondered (1) how frequently RT would be present but undetected in the figures from literature, especially before 2013; (2) whether it would be more prevalent in the era of small tidal volumes after 2000. Methods We searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials, from 1950 to 2017, with key words related to asynchrony to identify papers with figures including ventilator waveforms expected to display RT if present. Experts labelled waveforms. ‘Definite’ RT was identified when Pes or EAdi were in the tracing, and ‘possible’ RT when only flow and pressure waveforms were present. Expert assessment was compared to the author’s descriptions of waveforms. Results We found 65 appropriate papers published from 1977 to now, containing 181 ventilator waveforms. 21 cases of ‘possible’ RT and 25 cases of ‘definite’ RT were identified by the experts. 18.8% of waveforms prior to 2013 had evidence of RT. Most cases were published after 2000 (1 before vs. 45 after, p=0.03). 54% of RT cases were attributed to different phenomena. A few cases of identified RT were already described prior to 2013 using different terminology (earliest in 1997). While RT cases attributed to different phenomena decreased after 2013, 60% of ‘possible’ RT remained missed. RT has been present in the literature as early as 1997, but most cases were found after the introduction of low tidal volume ventilation in 2000. Following 2013, the number of undetected cases decreased, but RT are still commonly missed
dc.fechaingreso.objetodigital2024-06-06
dc.fuente.origenBiomed Central
dc.identifier.doi10.1186/s13613-024-01303-4
dc.identifier.urihttps://doi.org/10.1186/s13613-024-01303-4
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/86491
dc.information.autorucDepartamento de Ciencias de la Salud;Damiani Rebolledo, L. Felipe;0000-0002-8338-0488;237645
dc.language.isoen
dc.nota.accesocontenido completo
dc.revistaAnnals of Intensive Care
dc.rightsacceso abierto
dc.rights.licenseCC BY Attribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectLung Protective Ventilation
dc.subjectMechanical Ventilation
dc.subjectReverse Triggering
dc.subjectVentilator Asynchrony
dc.subject.ddc510
dc.subject.deweyMatemática física y químicaes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleReverse triggering ? a novel or previously missed phenomenon?
dc.typeartículo
dc.volumen14
sipa.codpersvinculados237645
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