Use of the esophageal catheter to detect asynchronies

Patient-ventilator asynchronies are more usual than we believe in critical care patients, and recognition of such an interaction can be challenging in clinical practice, especially if we don´t have advanced monitoring tools such as esophageal pressure tracing at the bedside. Reverse trigger, early cycling, and work shifting are types of asynchronies that must comply with some characteristics in the interaction between ventilator and patient, that could be difficult to detect only with visual analysis of usual waveforms curves showed in mechanical ventilators even for trained operators. In this sense, esophageal catheter is a very useful tool to correct detection and management, if required, of patient-ventilator interactions. Keywords: asynchrony, esophageal pressure, reverse trigger, work shifting.