Early Cycling: The Trigger Behind Double Triggering

Early cycling is a common cause of double triggering, where one patient effort initiates two consecutive breaths. In this example, the first breath is patient-triggered, evident from the pressure drop prior to inspiration and marked workshifting. Because the patient’s inspiratory effort continues beyond the ventilator’s early termination of inspiration, that same ongoing effort triggers a second breath immediately after the first. Thus, both breaths are patient-triggered, with the second breath arising from the continuation of the initial neural inspiratory effort.