Identifying asynchronies: Early cycling

Mechanical ventilation is a lifesaving treatment but can be associated with some complications such as ventilator-induced lung injury, ventilator associated pneumonia or ventilation induced diaphragm dysfunction. Although partial ventilatory support is preferred to limit some of the complications associated with controlled mechanical ventilation, there could be some problems like asynchrony between the patient and the ventilator. Asynchronies occur when the ventilator’s breath delivery does not match the patient’s ventilatory pattern or is inadequate to meet their flow demand. Asynchronies can lead to patient’s discomfort, prolong mechanical ventilation, intensive care unit stay and mortality. Early cycling occurs when the patient’s neural inspiratory time is longer than the inspiratory time imposed by the ventilator. It is a common cause of double trigger.