Expiratory dysynchrony is a major unrecognized problem in critical care. Usually it takes one of two forms: a terminal upstroke on the pressure waveform, indicating pressure cycling (breath too long) or a W shaped anomaly in the expiratory flow waveform – indicative of the breath being too short or too long. I call this the “Wibbly Wobbly Waveform”.

This tutorial looks at expiratory dysynchrony – why it happens and how to make adjustments to resolve the problem. I also introduce a relatively new technology: IE Sync.