Effects of increasing the cycling-off threshold according to prolonged (A) or short (B) time constant of the respiratory system. Effects of increasing.

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Presentation transcript:

Effects of increasing the cycling-off threshold according to prolonged (A) or short (B) time constant of the respiratory system. Effects of increasing the cycling-off threshold according to prolonged (A) or short (B) time constant of the respiratory system. Increasing the cycling-off threshold (CT) (Galileo Gold, Hamilton Medical, Rhäzuns, Switzerland) from 10% to 50–75% in patients with a prolonged time constant (COPD) eliminates wasted efforts. In contrast, panel B shows that increasing the cycling-off threshold (Puritan-Bennett 840, Mallinckrodt, Pleasanton, California) from 5% to 45% in patients with a short time constant (acute lung injury or acute respiratory distress syndrome) induces double-triggering or premature opening of the exhalation valve. The arrows (A) point to wasted efforts. The first arrow (B) points to double-triggering. The second arrow (B) points to premature opening of the exhalation valve. Paw = airway pressure. PTD = transdiaphragmatic pressure. EMG = electromyogram signal of diaphragmatic electrical activity. VT = tidal volume. Pes = esophageal pressure. (Adapted from References 23 and 24, with permission.)‏ Catherine SH Sassoon Respir Care 2011;56:39-51 (c) 2012 by Daedalus Enterprises, Inc.