Inspiratory effort and occlusion pressure in triggered mechanical ventilation

We have studied eleven patients ventilated in the assisted mode during recovery from acute respiratory failure. We have measured the effort required to trigger the pressure demand valve for 3 different ventilators, and have measured the occlusion pressure as an index of neuromuscular inspiratory drive. We found a delay in the opening of the demand valve, as previously described by other authors. We also found a close correlation between the effort required to open the demand valve and the occlusion pressure. We conclude that the inspiratory effort required to open the demand valve, in the assist mode, is greater than the preset trigger level and that it is well correlated with the neuromuscular inspiratory drive. This inspiratory effort against the closed demand valve, allows the measurement of the occlusion pressure.