Mechanical Ventilation Controlled by the Electrical Activity of the Patient's Diaphragm - Effects of Changes in Ventilator Parameters on Breathing Pattern

Inclusion criteria

• Invasive mechanical ventilation (tracheally intubated or tracheotomized)
• Presence of an arterial pressure line.
• Subject itself or its next of kin has given written informed consent

Exclusion criteria

• Patient is less than 18 years or more than 85 years of age
• The attending physician refuses to allow enrollment
• The patient refuses informed consent
• Next of kin is unavailable or refuses informed consent
• Pregnant or breast-feeding female. A pregnancy test will be performed in all female patients less than 60 years of age.
• Any contraindication to insertion/exchange a nasogastric tube, including (but not limited to): severe oropharyngeal malformation or bleeding; esophageal varices, tumor, infection, stenosis, or rupture
• Presence or suspicion of diaphragm injury
• Hemophilia or other severe bleeding disorder
• Presence or suspicion of a central nervous system (CNS) disorder, including (but not limited to): CNS infarction, bleeding, tumor, or infection
• History of heart and/or lung transplantation
• Any mechanical cardiac assist device (excluding intraaortic balloon pump)
• Any contraindication to reduce sedation or to stop neuromuscular blockage in order to allow spontaneous breathing
• The patient needs to be ventilated with a mode of mechanical ventilation that targets a predefined tidal volume or airway pressure as per attending physician
• Severe hemodynamic instability as per attending physician
• Planned or anticipated intervention within the study period necessitating either transfer out of the ICU or requiring prolonged interaction with the patient.
• A fraction of inspired oxygen (FiO2) of > 0.8
• The patient currently participates in another interventional clinical trial