Looks Like Early Cycling? Think Again- It's Delayed Cycling

I'm sharing this image to illustrate that an upward deflection in the first half of the expiratory flow-time curve can sometimes be misinterpreted as an early cycling dyssynchrony.

In this instance, the upward deflection in the expiratory flow-time curve was caused by a failed trigger. The patient completed one breath within the predetermined inspiratory time and began inhaling during the early expiratory phase, leading to the observed upward deflection. This particular scenario can occur when the patient's spontaneous respiratory rate is very high compared to the set respiratory rate. 

Switching the mode can sometimes aid in detecting patient-ventilator dyssynchrony. In this case, we switched to pressure support mode to know the patient's breathing pattern. Here, you can observe that the patient's spontaneous respiratory rate was so high that he was able to complete one breath and initiate the next breath within a one-second interval.