Journal Information
Vol. 47. Issue 5.
Pages 313-314 (May 2023)
Images in Intensive Medicine
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Reverse triggering
Trigger reverso
V. Yordanov Zlatkova,
Corresponding author

Corresponding author.
, C. Mayordomo Garcíab, A. Núñez Reiza
a Servicio de Medicina Intensiva, Hospital Clínico San Carlos, Madrid, Spain
b Servicio de Medicina Intensiva, Hospital Clínico Lozano Blesa, Zaragoza, Spain
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The image (Fig. 1) shows a registry of the electrical activity of the diaphragm using a neurally adjusted ventilatory assist (NAVA) esophageal catheter in a patient being ventilated in pressure control mode. The figure at the bottom superimposes two registries: pressure-time (yellow tracing) and electrical activity-time (grey tracing).

Figure 1

All inspirations are mandatory (yellow arrows). However, during each mandatory inspiration, the patient experiences spontaneous inspiration reflected by an increase in electrical activity of the diaphragm (grey arrows). This event coincides in time with a series of negative inflections in the pressure registry (white asterisks).

The registry corresponds to a patient with acute respiratory distress syndrome who suffers reverse triggering.

Conflicts of interest


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