PMID: 3756051Sep 1, 1986Paper

Excessive work of breathing during intermittent mandatory ventilation

British Journal of Anaesthesia
J S MecklenburghW W Mapleson

Abstract

Difficulties were experienced in weaning a patient from a ventilator by means of intermittent mandatory ventilation (IMV). The difficulty was overcome by installing an alternative IMV system (Hudson "disposable IMV valve") through which the patient drew her spontaneous breaths. Laboratory measurements showed that the resistance of the ventilator breathing system was much higher than that of the alternative system, mainly as a result of the resistance of the humidifier. It was calculated from measurements with a preset pattern of simulated breathing that the extra, external, work of breathing through the ventilator breathing system was approximately 1.5 times the normal internal mechanical work of breathing for a normal patient; with the alternative system, the extra work was only 0.5 times the normal. It is stressed that the breathing systems of IMV ventilators should be judged with the same rigour as other systems through which the patient is required to breathe spontaneously. It is recommended that manufacturers should provide the necessary information.

Citations

May 1, 1993·International Journal of Clinical Monitoring and Computing·T E OhY H Tam
Jan 5, 1995·The New England Journal of Medicine·M H Kollef, D P Schuster
May 1, 1995·Anaesthesia·J C Taylor, G T Bell
Jul 1, 1989·The American Review of Respiratory Disease·G E TzelepisF G Hoppin
Nov 30, 2000·Critical Care : the Official Journal of the Critical Care Forum·G A IottiA Braschi
Jan 1, 1988·Intensive Care Medicine·D CoxJ G Farrimond
Sep 1, 1988·Journal of Medical Engineering & Technology·B Hayes
Oct 23, 1997·Critical Care Medicine·N R MacIntyreA Sane
Jan 1, 1988·Intensive Care Medicine·L F Samodelov, K J Falke

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