What type of asynchrony can you see? #7

Delayed cycling. This occurs when the mechanical inspiration extends into neural expiration.

• Fast decrease in inspiratory flow followed by an exponential decline in inspiratory flow (less steep)
• Also look for an abrupt increase in Paw near the end of inspiration on the pressure waveform

In pressure-support ventilation:

• Cycling criteria (expiratory trigger sensitivity) set too low
• Pressure support too high
• Pressure ramp too long

In pressure-controlled ventilation:

• Cycling criteria (expiratory trigger sensitivity) set too low
• Inspiratory time too long

In volume-controlled ventilation:

• Low flow
• Long inspiratory time
• High tidal volume

• Increase expiratory trigger sensitivity (ETS)
• Decrease inspiratory time (TI)
• Decrease ventilation parameters (pressure support [PS], tidal volume [Vt], pressure ramp [P-ramp], etc.)