From the Guidelines
The advantage of a pressure-triggered mode of ventilation is that minimal work of breathing is wasted on triggering. This is because pressure-triggered ventilation detects the patient's inspiratory effort and delivers a breath in response, allowing for a more natural breathing pattern and reducing the work of breathing required to trigger the ventilator 1. According to the BTS/ICS guideline for the ventilatory management of acute hypercapnic respiratory failure in adults, pressure-targeted ventilation has several advantages, including compensating for air leak and providing positive pressure throughout expiration, which aids triggering and counteracts upper airway collapse during expiration 1.
Key Points
- Pressure-triggered ventilation reduces the work of breathing required to trigger the ventilator
- It allows for a more natural breathing pattern, reducing the need for heavy sedation
- Proper setup and monitoring are essential to prevent auto-triggering from circuit leaks or cardiac oscillations
- The BTS/ICS guideline recommends the use of pressure-targeted ventilation for non-invasive ventilation (NIV) due to its advantages over volume control ventilation 1
In contrast to other modes of ventilation, pressure-triggered ventilation is more sensitive to the patient's own respiratory effort, making it a more comfortable and effective option for patients requiring mechanical ventilation. As noted in the study by Davidson et al., ventilators designed for NIV usually employ a single lumen circuit, and a minimum EPAP of 3 cm is required to vent 1. Overall, the use of pressure-triggered ventilation can lead to improved patient outcomes, including shorter ventilation times and fewer complications from sedative medications.
From the Research
Advantages of Pressure-Triggered Mode of Ventilation
- Minimal work of breathing is wasted on triggering: This is because pressure-triggered ventilation is designed to assist the patient's spontaneous breathing efforts, reducing the amount of work required to trigger a breath 2.
- Reduces inappropriate "auto-triggering": Pressure-triggered ventilation can help minimize auto-triggering, which occurs when the ventilator delivers a breath without a patient's effort, by requiring a patient-generated pressure signal to trigger a breath 2.
Other Options
- Requires the least sedation of all trigger settings: There is no direct evidence to support this claim as an advantage of pressure-triggered mode of ventilation 3, 4, 5, 6.
- Guarantees a minute volume: This is not a characteristic of pressure-triggered ventilation, as it is designed to support spontaneous breathing and may not guarantee a specific minute volume 3, 4, 5, 6.