Patient-Triggered Ventilation: How Does the Trigger Work?

FOR THE VAST MAJORITY OF neonates requiring ventilation in our NICUs today, we use what is called patient-triggered ventilation (PTV)—synchronized intermittent mandatory ventilation, assist/control ventilation, or pressure support ventilation (Table 1). Also called synchronized ventilation, PTV has long been used successfully in adults. The goal of PTV is to prevent asynchronous breathing against the ventilator, which has been shown to contribute to pneumothorax in the neonate and subsequently to an increased risk of intraventricular hemorrhage in preterm infants.1,2 Other short-term benefits of PTV include improvements in oxygenation and carbon dioxide elimination, reduced variability in cerebral blood flow, and a shorter duration of mechanical ventilation.3