Double triggering

Volume, flow, and pressure waveforms, respectively, illustrating two simulations of asynchrony. The first three waveforms (panel A) represent a case in which the first breath is always triggered by the patient during volume-controlled ventilation. The dots indicate stacked tidal volume caused by double triggering. The bottom three waveforms (panel B) represent a case of reverse triggering due to respiratory muscle effort triggered by reflex mechanisms resulting from a ventilator-delivered breath, during pressure-controlled ventilation. Note, in both cases, stacked tidal volume and increased airway pressure during asynchrony. The dots indicate reverse triggering.