{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T18:31:29Z","timestamp":1770834689890,"version":"3.50.1"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T00:00:00Z","timestamp":1636675200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Patient-ventilator asynchrony is common during pressure support ventilation (PSV) because of the constant cycling-off criteria and variation of respiratory system mechanical properties in individual patients. Automatic adjustment of inspiratory triggers and cycling-off criteria based on waveforms might be a useful tool to improve patient-ventilator asynchrony during PSV.<\/jats:p><jats:p><jats:bold>Method:<\/jats:bold> Twenty-four patients were enrolled and were ventilated using PSV with different cycling-off criteria of 10% (PS<jats:sub>10<\/jats:sub>), 30% (PS<jats:sub>30<\/jats:sub>), 50% (PS<jats:sub>50<\/jats:sub>), and automatic adjustment PSV (PS<jats:sub>AUTO<\/jats:sub>). Patient-ventilator interactions were measured.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The total asynchrony index (AI) and NeuroSync index were consistently lower in PS<jats:sub>AUTO<\/jats:sub> when compared with PS<jats:sub>10<\/jats:sub>, PS<jats:sub>30<\/jats:sub>, and PS<jats:sub>50<\/jats:sub>, (<jats:italic>P<\/jats:italic> &amp;lt; 0.05). The benefit of PS<jats:sub>AUTO<\/jats:sub> in reducing the total AI was mainly because of the reduction of the micro-AI but not the macro-AI. PS<jats:sub>AUTO<\/jats:sub> significantly improved the relative cycling-off error when compared with prefixed controlled PSV (<jats:italic>P<\/jats:italic> &amp;lt; 0.05). PS<jats:sub>AUTO<\/jats:sub> significantly reduced the trigger error and inspiratory effort for the trigger when compared with a prefixed trigger. However, total inspiratory effort, breathing patterns, and respiratory drive were not different among modes.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> When compared with fixed cycling-off criteria, an automatic adjustment system improved patient-ventilator asynchrony without changes in breathing patterns during PSV. The automatic adjustment system could be a useful tool to titrate more personalized mechanical ventilation.<\/jats:p>","DOI":"10.3389\/fmed.2021.752508","type":"journal-article","created":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T05:09:07Z","timestamp":1636693747000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Automatic Adjustment of the Inspiratory Trigger and Cycling-Off Criteria Improved Patient-Ventilator Asynchrony During Pressure Support Ventilation"],"prefix":"10.3389","volume":"8","author":[{"given":"Ling","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoting","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qin","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haibo","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Chiumello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1097\/CCM.0b013e3181cb0d7b","article-title":"Patient-ventilator interaction during pressure support ventilation and neurally adjusted ventilatory assist","volume":"38","author":"Spahija","year":"2010","journal-title":"Crit Care Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1378\/chest.104.2.560","article-title":"Clinically available new strategies for mechanical ventilatory support","volume":"104","author":"MacIntyre","year":"1993","journal-title":"Chest."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2143","DOI":"10.1152\/jappl.2000.88.6.2143","article-title":"Analysis of the mechanisms of expiratory asynchrony in pressure support ventilation: a mathematical approach","volume":"88","author":"Yamada","year":"2000","journal-title":"J Appl Physiol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1097\/00000539-200101000-00031","article-title":"The effect of breath termination criterion on breathing patterns and the work of breathing during pressure support ventilation","volume":"92","author":"Tokioka","year":"2001","journal-title":"Anesth Analg."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.1164\/rccm.200407-880OC","article-title":"Impact of expiratory trigger setting on delayed cycling and inspiratory muscle workload","volume":"172","author":"Tassaux","year":"2005","journal-title":"Am J Respir Crit Care Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.1007\/s00134-006-0301-8","article-title":"Patient-ventilator asynchrony during assisted mechanical ventilation","volume":"32","author":"Thille","year":"2006","journal-title":"Intensive Care Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1164\/ajrccm.152.1.7599811","article-title":"Variability of patient-ventilator interaction with pressure support ventilation in patients with chronic obstructive pulmonary disease","volume":"152","author":"Jubran","year":"1995","journal-title":"Am J Respir Crit Care Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1058","DOI":"10.1164\/rccm.201212-2214CI","article-title":"Patient-ventilator interactions. 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