This patient is being ventilated noninvasively in pressure-support mode. What does the red circle on the pressure and flow waveforms indicate?
Answer: Double triggering.
Double triggering refers to two mechanical breaths with a single patient inspiratory effort. The first breath cycles prematurely and as the patient is still making an inspiratory effort, a second mechanical breath is triggered.
Double triggering is due to premature cycling and/or insufficient pressure support, which forces the patient to make strong inspiratory efforts.
Therefore, when the waveforms indicate double triggering, the expiratory trigger should be prolonged and/or pressure support increased.
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