Respiratory care最新文献

{"title":"Long-Term Mechanical Insufflation-Exsufflation Practice: A Norwegian National Survey After More Than 20 Years' Experience.","authors":"Tiina M Andersen, Ester Nørstebø, Brit Hov","doi":"10.1089/respcare.12874","DOIUrl":"https://doi.org/10.1089/respcare.12874","url":null,"abstract":"<p><p><b>Background:</b> As knowledge of mechanical insufflation-exsufflation (MI-E) expands, understanding factors influencing home use is essential to promote effective therapy. This study aimed to determine the prevalence of MI-E long-term users in Norway and describe clinicians' self-reported experience and independence with MI-E, cough assessment practices, and MI-E initiation and follow-up in a country with over 20 years of experience. <b>Methods:</b> This cross-sectional study used 4 data sources (1) Norwegian Units for Medical Home-Care Equipment provided data on MI-E users, (2) Statistics Norway provided the overall count of the Norwegian population, (3) The Norwegian Patient Registry supplied population data on specialist health care service use, and (4) a survey of multidisciplinary clinicians collected self-reported data on clinicians MI-E confidence and practices. <b>Results:</b> In 2023, 1,131 individuals in Norway (16% under 18 years) used MI-E devices for long-term treatment, with a prevalence of 53.5 per 100,000 among specialist health care service users and 20.6 per 100,000 in the total population. Of 182 survey respondents, 163 reported MI-E experience, primarily physiotherapists (78%), followed by nurses (13%) and physicians (9%). Physiotherapists had the longest experience and highest confidence in independently initiating MI-E and assisting colleagues. Most clinicians (77%) used multiple methods to assess cough effectiveness, including qualitative assessment, cough peak flow, and swallowing evaluation. Follow-up practices varied widely 43% used patient journals, 5% digital registries, 10% paper records, 27% unspecified overview of MI-E users for follow-up purposes, and 15% had no systematic overview. Regular follow-ups were reported by 43%, whereas 19% followed up only on patient request, 30% were unaware of local routines, and 8% reported no follow-up routines. <b>Conclusions:</b> The MI-E prevalence highlights its role as a substantial therapy for individuals with rare disorders. Variability in follow-up practices underscores the need for standardized guidelines to improve consistency and quality in long-term MI-E care.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Airway Management and Intubation Support Competency Assessment Tool.","authors":"Katherine S Reise, Roger Correia, Cristina Bertazzo, Alisha Jabar, Graham A McCreath, Catharine M Walsh","doi":"10.1089/respcare.12889","DOIUrl":"https://doi.org/10.1089/respcare.12889","url":null,"abstract":"<p><p><b>Background:</b> Assessment tools for health professionals providing airway management and team support during airway events are essential to facilitate learning and document competence. We aimed to evaluate the validity of evidence of the Pediatric Airway Management and Intubation Support (PAMIS) tool for use in assessing the competency of respiratory therapists (RTs) assisting with pediatric intubation in a simulated environment. <b>Methods:</b> The PAMIS tool, developed based on task deconstruction, comprises 10 items assessing 3 core competency domains (manual ventilation, intubation preparation and assistance, and interprofessional team collaboration) and a global rating of performance. Novice and intermediate RT trainees and experienced registered RTs performed a simulated airway management scenario that was assessed independently by 2 live raters and 2 blinded video-based raters using the PAMIS tool. Fifteen videos were also re-evaluated by blinded raters 3 months later. Validity evidence for the tool was generated following Messick's validity framework, including evidence of content, response process, internal structure, and relations with other variables. <b>Results:</b> We analyzed assessments for 51 participants (15 novice, 21 intermediate, and 15 experienced participants) completed by 10 assessors. Internal consistency was acceptable (α = 0.75), with item-total correlations ranging from 0.17 to 0.74. Inter-rater reliability was high for both live (intraclass correlation coefficient [ICC] = 0.97) and video-based assessments (ICC = 0.85), with strong agreement between the 2 assessment modalities (ICC = 0.94). Test-retest reliability was excellent (ICC = 0.92). PAMIS scores differed significantly based on experience level (<i>P</i> < .001) and correlated highly with a global assessment of performance ratings (<i>r</i> = 0.89, <i>P</i> < .001). Both live and video-based ratings were perceived as user-friendly, with live assessments perceived as easier to use. <b>Conclusions:</b> The PAMIS tool demonstrated strong validity evidence for use as a formative assessment of competence for RTs providing pediatric airway management and intubation assistance within a simulated setting. This study presents a validated assessment tool designed to support competency-based RT education and practice.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway Obstruction in Patients With Left-Ventricular Hypertrophy.","authors":"Priyavardhan Mishra, Anant Patil, Nikhil Sarangdhar, Pannag Bhushan Biswal, Mohit Kondisetti, Girija Nair","doi":"10.1089/respcare.12550","DOIUrl":"https://doi.org/10.1089/respcare.12550","url":null,"abstract":"<p><p><b>Background:</b> The relationship between left-ventricular hypertrophy (LVH), left-ventricular mass index (LVMI), body mass index (BMI), and their corresponding pulmonary function test parameters remains unknown. <b>Methods:</b> In this prospective observational study, we assessed the pulmonary function of subjects with LVH. The severity of airway obstruction was graded into five levels using the FEV₁% predicted value and the prevalence of obstruction with left-ventricular mass was also correlated. <b>Results:</b> Our study included 289 subjects [142 (49.1%) LVH and 147 (50.8%) non-LVH]. The mean age of subjects with LVH was 56 ± 17.8 years. Sixty-two subjects with normal BMI had LVH. One-hundred forty-two subjects with LVH underwent spirometry; 9 (6.3%), 16 (11.3%), 18 (12.7%), 49 (34.5%), and 48 (33.8%) had mild, moderate, moderately severe, severe, and very severe obstruction before the administration of bronchodilator, respectively. After bronchodilator administration, the numbers (n%) were 13 (9.15%), 17 (11.9%), 27 (19%), 52 (36.6%), and 30 (21.1%), respectively. There was a strong inverse relationship (r = -0.87, r = -0.86) for pre bronchodilator and post bronchodilator, respectively; R² = 0.76 and R² = 0.74 for pre and post bronchodilator respectively, <i>P</i> < .001 for both) between LVMI and FEV₁%. <b>Conclusions:</b> LVH was associated with high prevalence of obstructive pulmonary disease. The severity of obstruction was correlated with left-ventricular mass. The early screening of such underlying obstruction may help to reduce the risk of further complications.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Delirium on Hospitalized Patients With COPD Exacerbation: Insights From the National In-Patient Sample.","authors":"Pamela Ogbughalu, Yewande Odeyemi, Mohamad El Labban","doi":"10.1089/respcare.12913","DOIUrl":"https://doi.org/10.1089/respcare.12913","url":null,"abstract":"<p><p><b>Background:</b> Delirium in hospitalized patients has been consistently associated with worse clinical outcomes, including increased mortality and prolonged hospital stays. COPD exacerbation is a common reason for hospitalization, and understanding the impact of delirium on this population is crucial for improving patient care and outcomes. <b>Methods:</b> We conducted a retrospective cohort study using the National In-Patient Sample dataset to assess the impact of delirium on patients hospitalized with COPD exacerbation. Subjects were identified using International Classification of Diseases, 10th Revision, codes for COPD exacerbation and delirium. Baseline characteristics and outcomes, including in-patient mortality and the use of invasive mechanical ventilation, were compared between subjects with and without delirium using chi-square analysis. Multivariate regression analysis was used to adjust for potential confounders. <b>Results:</b> A total of 8,062,333 subjects hospitalized with COPD exacerbation were included, of whom 574,005 (7.2%) had a diagnosis of delirium. Most subjects in both groups were white, covered by Medicare, and treated in large urban teaching hospitals. Subjects with delirium had higher rates of dementia, malnutrition, and chronic kidney disease. The rates of in-patient mortality (13.85% vs 4.29%, <i>P</i> < .01) and use of invasive mechanical ventilation (26.7% vs 7.79%, <i>P</i> < .01) were significantly higher in the delirium group. Delirium was associated with higher odds of mortality (adjusted odds ratio [aOR] 2.48, <i>P</i> < .01) and use of mechanical ventilation (aOR 3.92, <i>P</i> < .01). Subjects with delirium had longer and more costly hospital stays. <b>Conclusions:</b> Delirium was associated with worse outcomes in subjects hospitalized with COPD exacerbation.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and Practice of Mechanical Ventilation Humidification Systems in Latin American ICUs.","authors":"Gustavo A Plotnikow, Roque S Moracci, Facundo J Gutiérrez, Mariano Setten, Javier Mariani","doi":"10.1089/respcare.12771","DOIUrl":"https://doi.org/10.1089/respcare.12771","url":null,"abstract":"<p><p><b>Background:</b> Humidification of inspired gases is critical for maintaining airway integrity in mechanically ventilated patients. However, airway instrumentation and the use of cold, dry medical gases can disrupt this process, necessitating external humidification systems. This study aimed to assess knowledge and practices regarding humidification systems in mechanical ventilation among health care professionals in Latin American ICUs. <b>Methods:</b> A cross-sectional, digital survey was conducted from April to August 2024, targeting ICU professionals across Latin America. The questionnaire assessed operational and clinical knowledge of heat-and-moisture exchangers (HMEs) and heated humidifiers, as well as their use in mechanical ventilation. Participants were recruited through professional societies and personal networks. Data were analyzed using descriptive and inferential statistics, with significance set at <i>P</i> < .05. <b>Results:</b> A total of 510 valid responses were analyzed, representing 20 countries. Most respondents were respiratory therapists (73%) with over 5 years of ICU experience (43%). HMEs were the first-line option for mechanical ventilation in 68% of cases, whereas 69% used humidification systems in noninvasive ventilation, favoring heated humidifiers. The median correct response rate showed significant differences by profession (<i>P</i> < .001) and education level (<i>P</i> < .001). Only 31% of respondents correctly identified the recommended minimum absolute humidity, and only 5.3% reported routine maintenance of heated systems. <b>Conclusions:</b> This study highlights critical gaps in knowledge and practices related to humidification systems in ICUs. The observed differences in performance based on profession and level of training suggest that continuing education and specialization are essential to optimize clinical practice.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Weight-Based High-Flow Nasal Cannula Flow Limits on Intensive Care Unit Utilization in Bronchiolitis.","authors":"Gerald B Moody, Sachin Shah, Ali Hasan, A Paige Davis Volk","doi":"10.1089/respcare.12525","DOIUrl":"https://doi.org/10.1089/respcare.12525","url":null,"abstract":"<p><p><b>Background:</b> High-flow nasal cannula (HFNC) is a common respiratory support device utilized in the management of children hospitalized with bronchiolitis. Early adoption in many pediatric wards was developed using age-based flow limits. However, age-based limits do not align with current evidence and potentially contribute to ICU admissions. To align with current evidence and improve ICU bed allocation, we implemented weight-based flow limits within our wards. The primary objective of this study was to evaluate the impact of these changes on ICU utilization. <b>Methods:</b> This retrospective study was conducted at Children's Medical Center in Plano, Texas, a free-standing, community-based hospital affiliated with an academic quaternary center. Subjects were patients < 2 years of age admitted for bronchiolitis and supported via HFNC in the 12 months before and after implementation of weight-based flow limits. Primary outcomes were ED disposition and ICU transfer rates. Secondary outcomes were evaluation of adverse respiratory events and stay. <b>Results:</b> A total of 1,207 subjects met inclusion criteria; 558 pre- and 649 post-implementation. There were no differences between groups in age, weight, or gender. Compared with the pre-implementation group, we observed an 8.6% absolute decrease in ICU admissions [92 (16.5%) vs 51 (7.9%)<i>, P</i> < .001], a 3% absolute decrease in ward to ICU transfers [28 (6%) vs 19 (3%)<i>, P</i> = .034], and no difference in escalation of respiratory support [6 (1.1%) vs 4 (0.6%)<i>, P</i> = .38] or escalation within one hour of transfer [0 (0%) vs 2 (50%)<i>, P</i> > .99]. Overall median stay decreased by 15.9 h in the post-implementation group, [59.4 (IQR 39.1- 85.9) vs 43.5 (IQR 26.9-67.2)<i>, P</i> < .001]. <b>Conclusions:</b> These findings suggest that for hospital systems utilizing similar age-based HFNC flow limits, transitioning to weight-based flows, with safeguards in place, may improve ICU bed utilization while maintaining comparable patient outcomes.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Tele-Critical Care in Managing Critically Ill Patients With COVID-19: Analysis of Outcomes From an Integrated Health System.","authors":"Heath D White, Valerie Danesh, Nithin Kesireddy, Edgar J Jimenez, Carl D Boethel, Gerald O Ogola, Anisha Shrestha, Alejandro C Arroliga","doi":"10.1089/respcare.12661","DOIUrl":"https://doi.org/10.1089/respcare.12661","url":null,"abstract":"<p><p><b>Background:</b> The implications of splitting medical management and advanced procedural care are unique to critical care medicine. As tele-critical care adoption accelerates, examining the equivalence between in-person intensivist care and tele-intensivist staffing is needed. We sought to examine the equivalence of patient outcomes associated with tele-intensivist and in-person intensivist care of critically ill patients with COVID-19. <b>Methods:</b> In this retrospective multi-center cohort study, 1,885 consecutive critical care hospitalizations of subjects with COVID-19 receiving tele-intensivist or in-person intensivist care at 5 hospitals in Texas participating in the Society of Critical Care Medicine Discovery Viral Respiratory Illness Universal Study COVID-19 registry were included. The main outcomes were mortality, length of stay, and duration of invasive ventilation. <b>Results:</b> Of the 1,885 ICU admissions, 491 (26%) were managed in 4 hospitals with tele-intensivist staffing and compared with 1,394 (74%) ICU admissions managed by the same intensivists via in-person staffing (1 hospital). Propensity score matching for controlled comparison of tele-intensivist and in-person intensivist groups revealed no difference in ICU or in-hospital mortality, length of stay, or duration of invasive ventilation. <b>Conclusions:</b> Mortality, length of stay, and duration of invasive ventilation of subjects receiving tele-intensivist care were similar to subjects in the same healthcare system receiving in-person intensivist care.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated Oxygen Titration With Noninvasive Respiratory Support in Acute In-Patient Care.","authors":"Louis W Kirton, Allie L Eathorne, Julie K Cook, Rowan J Hamill, Stacey M Kung, Alex C Semprini, Ruth A C Semprini, Mark Weatherall, Richard Beasley","doi":"10.1089/respcare.12745","DOIUrl":"https://doi.org/10.1089/respcare.12745","url":null,"abstract":"<p><p><b>Background:</b> When delivering high-flow nasal cannula (HFNC) therapy, automated oxygen titration increases time spent within a target S_pO₂ range compared with manually adjusted titration. This trial explored if this benefit is also achieved when CPAP or noninvasive ventilation (NIV) is used. <b>Methods:</b> This open label exploratory study randomized participants to automated oxygen titration or manual oxygen titration using a single respiratory support device capable of delivering HFNC, CPAP, and NIV. Participants were hospital in-patients requiring supplemental oxygen and one or more of HFNC, CPAP, and NIV; and could interchange between the three modalities according to clinical need. The primary outcome was the proportion of time spent within a target S_pO₂ range in participants who received ≥8 h of therapy. A secondary interaction analysis explored whether any difference between automated and manual titration differed by respiratory support modality. <b>Results:</b> A total of 68 participants received randomized therapy; 58 started on HFNC, 6 on CPAP, and 4 on NIV. A total of 62 had data for the primary end point, with median (interquartile range) proportion of time spent within the target S_pO₂ range with automated oxygen (<i>n =</i> 32) of 91.4% (84.3 to 97.5) versus 75.9% (64.0 to 87.8) with manually adjusted oxygen (<i>n =</i> 30); difference 13.9% (95% confidence interval 6.2-21.2), <i>P</i> < .001. The difference between automated and manual titration did not depend on respiratory support modality, <i>P</i>-interaction = .94. <b>Conclusions:</b> In hospitalized subjects predominantly receiving HFNC, automated oxygen titration had the effect of increasing time spent within a target S_pO₂ range compared with manual oxygen titration. Automated oxygen titration had a similar effect on a small subset of participants receiving CPAP and NIV.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Inhaled Treprostinil in Lung Transplant Candidates With Pulmonary Hypertension Associated With Interstitial Lung Disease.","authors":"Alexander D Yuen, Lorenzo Zaffiri, Victor Tapson, Reinaldo Rampolla, Yuri Matusov","doi":"10.1089/respcare.12900","DOIUrl":"https://doi.org/10.1089/respcare.12900","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Trigger Algorithms on Trigger Performance and Patient-Ventilator Synchrony.","authors":"Keisuke Morinishi, Taiga Itagaki, Yusuke Akimoto, Yusuke Chikata, Jun Oto","doi":"10.1089/respcare.12694","DOIUrl":"https://doi.org/10.1089/respcare.12694","url":null,"abstract":"<p><p><b>Background:</b> Patient-ventilator synchrony is essential for successful patient-triggered ventilation. This study compared the ability of a trigger algorithm, based on detailed analysis of flow changes (IntelliSync+, Hamilton Medical), to trigger patient breaths with conventional algorithms. <b>Methods:</b> Three models with different lung mechanics (normal, ARDS, and COPD) at 3 severities were simulated with a lung model ventilated in pressure control continuous mandatory ventilation or pressure control continuous spontaneous ventilation (PC-CSV). Inspiratory pressure above PEEP was set at 15 cm H₂O and PEEP at 5 cm H₂O. Inspiratory trigger was selected from IntelliSync+ (IS+insp), flow trigger (1- 5 L/min), or pressure trigger (-1 to -5 cm H₂O). In PC-CSV, expiratory trigger was set at IntelliSync+ (IS+exp) or cycling criteria (5%, 25%, and 40% for ARDS, normal, and COPD, respectively). Measurements were performed with and without leak (50% inspiratory tidal volume). Five breaths per condition were collected to calculate trigger delay time and asynchronous events. <b>Results:</b> For pressure trigger, none of the conditions resulted in 3 successfully triggered consecutive breaths. Overall trigger delay time was significantly longer with flow trigger than with IS+insp in normal (99 vs 81 ms without leak, <i>P</i> < .001; 98 vs 80 ms with leak, <i>P</i> < .001) and ARDS models (334 vs 223 ms without leak, <i>P</i> < .001; 320 vs 236 ms with leak, <i>P</i> = .02). Across all conditions, ineffective efforts occurred more frequently with flow trigger than with IS+insp (7.3% vs 1.5% without leak, <i>P</i> = .01; 10.8% vs 3.0% with leak, <i>P</i> = .01). In PC-CSV, overall cycling delay time with IS+exp was equivalent or longer compared with cycling criteria. <b>Conclusions:</b> In this lung model study, IS+insp demonstrated similar trigger time and fewer ineffective efforts compared with flow trigger even in simulated respiratory conditions, whereas cycling delay time was unaffected by IS+exp because of large variations between conditions.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}