A 58-year-old male with COPD exacerbation is intubated in the ICU. On day 2, he is on volume-controlled ventilation with a tidal volume of 8 mL/kg, rate 14/min, and PEEP 5 cm H₂O. ABG shows pH 7.28, PaCO₂ 58 mmHg, PaO₂ 85 mmHg on FiO₂ 0.6. The patient is triggering the ventilator 22 times per minute but only 14 breaths are being delivered. He is fighting the ventilator and sedation has been optimized. Which ventilation mode would be most appropriate to reduce patient-ventilator dyssynchrony and allow spontaneous breathing?
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