Susceptibility for Entrainment: Role of Ventilator Settings on the Occurrence of Reverse Triggering and Its Physiological Consequences - the SEVeRe Study

"With the ventilator on volume control and Vt at 6 ml/kg of predicted body weight (PBW) (standard clinical practice), an end-expiratory occlusion of 30 seconds on the ventilator will be performed to search for intrinsic respiratory rate (RR). The set RR will be modified from 6 breaths per minute (bpm) below up to 6 bpm above the clinical RR in steps of 2 bpm every 1 minute (random order). The changes in RR described above will be repeated with Vt set at 5, 7 and 8 ml/kg PBW (random order). The steps described above will be aborted at any point if SpO2 drops below 85% for at least two minutes, mean arterial pressure drops below 60 mmHg, or plateau pressure \>35 cmH2O.~If an intrinsic respiratory rate ≥8 bpm is present and P/F ratio is ≥150, it will be propose to the clinician to place the patient in pressure support at a level preferred by clinicians for 5 minutes. If the patient tolerates well, it will be propose to the clinician to maintain the patient in pressure support ventilation,"