When flow dyssynchrony occurs in VC modes, the first reaction is often to increase the flow rate. Reasonable… but it often fails! Why? Maybe because any fixed (or fixed decelerating) flow can have trouble matching the patient effort at all stages of inspiration. Example:
Here the flow starvation occurs in the latter part of the breath, not the start, creating a biphasic appearance to the flow curve. What if we simply increase the flow? 
It’s no better! Now flow is probably too high at the start (initial flow overshoot as evidenced by the steep pressure spike)… but still inadequate at the end. Also, the pressure spike and resulting short I-time contributes to some double triggers.
Solution? Switch to a variable-flow mode, ie with a pressure limit (PC, PS). Flow now can change during the breath to match the curve of effort.
Start with increasing the flow in VC, but with significant effort, this is usually what you’ll need!
#medtwitter #ventrounds #FOAMcc
Start with increasing the flow in VC, but with significant effort, this is usually what you’ll need!
#medtwitter #ventrounds #FOAMcc
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