Chest ACCP Career Connection
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Marini, J. J.
Right arrow Articles by Culver, B. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Marini, J. J.
Right arrow Articles by Culver, B. H.

Chest, Vol 87, 612-618, Copyright © 1985 by American College of Chest Physicians

ARTICLES

The inspiratory work of breathing during assisted mechanical ventilation

JJ Marini, JS Capps and BH Culver

We quantified the mechanical work of breathing in six normal subjects during assisted mechanical ventilation. Using two volume-cycled ventilators of different design, we investigated the influence of minute ventilation (VE) and machine settings of trigger sensitivity and flow during CO2-driven hyperventilation to moderate and high levels (12- 24 L/min). Work estimates were derived from plots of esophageal and airway pressure against inflation volume. Peak flow and trigger sensitivity were important determinants of the energy expended, and for each combination of machine settings the work done by the subject per liter of ventilation increased with VE. During assisted ventilation the subject expended energy equivalent to 33-50 percent of the work of passive inflation, even under the most favorable conditions of VE, sensitivity and flow. Under the least favorable conditions of VE, sensitivity and flow, the subject's inspiratory work of breathing substantially exceeded the energy needed by the ventilator to inflate the passive thorax. These observations imply that exertion of the respiratory muscles continues throughout inflation during assisted mechanical ventilation and call attention to the possibility that inappropriate selection of ventilatory mode or machine settings may contribute to respiratory muscle fatigue and dyspnea.


This article has been cited by other articles:


Home page
 Eur Respir JHome page
G. Prinianakis, M. Delmastro, A. Carlucci, P. Ceriana, and S. Nava
Effect of varying the pressurisation rate during noninvasive pressure support ventilation
Eur. Respir. J., February 1, 2004; 23(2): 314 - 320.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
D. Chiumello, P. Pelosi, E. Calvi, L.M. Bigatello, and L. Gattinoni
Different modes of assisted ventilation in patients with acute respiratory failure
Eur. Respir. J., October 1, 2002; 20(4): 925 - 933.
[Abstract] [Full Text] [PDF]

Home page
 SEMIN CARDIOTHORAC VASC ANESTHHome page
R. M. Kacmarek
Ventilatory Muscle Function
Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2002; 6(3): 189 - 201.
[Abstract] [PDF]

Home page
 ThoraxHome page
N Ambrosino and A Rossi
Proportional assist ventilation (PAV): a significant advance or a futile struggle between logic and practice?
Thorax, March 1, 2002; 57(3): 272 - 276.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
D. Chiumello, P. Pelosi, M. Croci, L.M. Bigatello, and L. Gattinoni
The effects of pressurization rate on breathing pattern, work of breathing, gas exchange and patient comfort in pressure support ventilation
Eur. Respir. J., July 1, 2001; 18(1): 107 - 114.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
M. J. Tobin
Advances in Mechanical Ventilation
N. Engl. J. Med., June 28, 2001; 344(26): 1986 - 1996.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
F. LAGHI, J. SEGAL, W. K. CHOE, and M. J. TOBIN
Effect of Imposed Inflation Time on Respiratory Frequency and Hyperinflation in Patients with Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., May 1, 2001; 163(6): 1365 - 1370.
[Abstract] [Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. TOBIN, A. JUBRAN, and F. LAGHI
Patient-Ventilator Interaction
Am. J. Respir. Crit. Care Med., April 1, 2001; 163(5): 1059 - 1063.
[Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
F. LAGHI, K. KARAMCHANDANI, and M. J. TOBIN
Influence of Ventilator Settings in Determining Respiratory Frequency during Mechanical Ventilation
Am. J. Respir. Crit. Care Med., November 1, 1999; 160(5): 1766 - 1770.
[Abstract] [Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. PARTHASARATHY, A. JUBRAN, and M. J. TOBIN
Cycling of Inspiratory and Expiratory Muscle Groups with the Ventilator in Airflow Limitation
Am. J. Respir. Crit. Care Med., November 1, 1998; 158(5): 1471 - 1478.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
T. F. Schuessler, S. B. Gottfried, and J. H. T. Bates
A model of the spontaneously breathing patient: applications to intrinsic PEEP and work of breathing
J Appl Physiol, May 1, 1997; 82(5): 1694 - 1703.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
P. ASLANIAN, S. E. ATROUS, D. ISABEY, E. VALENTE, D. CORSI, A. HARF, F. LEMAIRE, and L. BROCHARD
Effects of Flow Triggering on Breathing Effort During Partial Ventilatory Support
Am. J. Respir. Crit. Care Med., January 1, 1997; 157(1): 135 - 143.
[Abstract] [Full Text]

Home page
 NEJMHome page
M. J. Tobin
Mechanical Ventilation
N. Engl. J. Med., April 14, 1994; 330(15): 1056 - 1061.
[Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1985 by the American College of Chest Physicians.