Reverse triggering is the ventilator-triggered muscular effort, related to entrainment, particularly seen among sedated patient. The reverse triggering frequently caused double triggering/double cycling, with increased tidal volume and transpulmonary pressure. In our monitored patients we have observed different types of double triggering caused by asynchrony like to reverse triggering, for which we adopted the term “pseudo-reverse-triggering”. To our knowledge, we described this asynchrony for the first time both in assist-controlled ventilation as well as during pressure support ventilation. These asynchronies must be recognized in clinical practice to be corrected in a personalized way.

Reverse triggering; Pseudo-reverse-triggering; Double triggering; Double cycling; Advanced respiratory monitoring