Ventilation of denervated transplanted lung at risk for overdistention by reverse triggering and breath stacking: a role for the paradoxical reflex of Head. Comment on Br J Anaesth 2022; 129: e1e4
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British Journal of Anaesthesia
Abstract
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Fil: Santa Cruz, Roberto. Instituto Universitario de Ciencias de la Salud. Fundación Barceló; Argentina.
EditordWe read with interest the description of respiratory monitoring performed on a 33-yr-old patient who developed pneumonia after receiving a double lung transplant.1 The authors describe that the patient experienced reverse triggering and breath stacking during mechanical ventilation. In the case of reverse triggering, the authors describe that according to proposed phenotypes,2 the patient had midcycle reverse triggering, where diaphragmatic contraction begins during passive lung inflation, thus generating a reduction in expiratory flow and air trapping, which can lead to overdistension. In this example, the electrical activity of the diaphragm (EAdi) indicated respiratory entrainment with the presence of reverse triggering.
EditordWe read with interest the description of respiratory monitoring performed on a 33-yr-old patient who developed pneumonia after receiving a double lung transplant.1 The authors describe that the patient experienced reverse triggering and breath stacking during mechanical ventilation. In the case of reverse triggering, the authors describe that according to proposed phenotypes,2 the patient had midcycle reverse triggering, where diaphragmatic contraction begins during passive lung inflation, thus generating a reduction in expiratory flow and air trapping, which can lead to overdistension. In this example, the electrical activity of the diaphragm (EAdi) indicated respiratory entrainment with the presence of reverse triggering.
Keywords
MEDICINA, VENTILACION MECANICA, TRASPLANTE DE PULMON