Check for causes:

Increased airway resistance- if so give bronchodilators

Anxiety–> increased RR + muscle tension–> increased airway resistance –> increased demand: Optimise sedation

Check for leaks in circuit and correct

If flow rate seems too low: Set higher inspiratory flow rate or reduce inspiratory time especially if patient is showing tachypnea

If Tidal volume or RR set too low: Increase it

Double triggering or breath stacking can happen if inspiratory time set is lower compared to that of the patient and ventilatory demand is high: Try increasing the inspiratory time or change to pressure control modes

NB:

Peak Inspiratory Pressure high with normal Plateau Pressure = it’s Increased airway resistance

Both (a)Peak Inspiratory Pressure and (b)Plateau Pressure are high and (a)-(b) is normal= it’s reduced compliance or auto peep

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