Authors: Marc van Heerde, Huib R van Genderingen, Tom Leenhoven, Karel Roubík, Frans B Plötz, Dick G Markhors
van Heerde M, van Genderingen HR, Leenhoven T, Roubik K, Plötz FB, Markhorst DG. Imposed Work of Breathing During High-Frequency Oscillatory Ventilation: A Bench Study. Critical Care 2006; 10(1); R23
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The article deals with imposed work of breathing and possibility of spontaneous breathing during high-frequency oscillatory ventilation (HFOV). The ventilator and the endotracheal tube impose additional workload in mechanically ventilated patients breathing spontaneously. The total work of breathing (WOB) includes elastic and resistive work. In a bench test we assessed the imposed WOB using 3100 A/3100 B SensorMedics high-frequency oscillatory ventilators.
Spontaneous breathing during HFOV resulted in considerable imposed WOB in pediatric and adult simulations, explaining the discomfort seen in those patients breathing spontaneously during HFOV. The level of imposed WOB was lower in the newborn and infant simulations, explaining why these patients tolerate spontaneous breathing during HFOV well. A high fresh gas flow rate reduced the imposed WOB. These findings suggest the need for a demand flow system based on patient need allowing spontaneous breathing during HFOV.
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