Autor: Jean-Michel Arnal, Senior Intensivist, Hopital Sainte Musse, Toulon, France
Data da primeira publicação: 03.12.2024
Why does the inspiratory flow have a rounded shape?
This patient has COPD associated with obesity. He was admitted for a severe exacerbation and treated with NIV using the NIV mode. PEEP is 4 and pressure support is 10 cmH2O. What is causing the inspiratory flow to have a rounded shape?
The rounded shape of the inspiratory flow suggests a large patient inspiratory effort as can be seen on the esophageal pressure waveform above. The swing in esophageal pressure during inspiration is around 15 cmH2O. In this case, increasing the level of pressure support should decrease the patient’s effort.