Effects of expiratory flow resistance on inspiratory work of breathing.

Abstract:

:To minimize work of breathing, airway pressure should not fluctuate during spontaneous breathing with continuous positive airway pressure (CPAP). However, flow resistance in the inspiratory limb of the breathing circuit and an inadequate continuous gas flow rate result in airway pressure fluctuation and increased work of breathing. Flow resistance of the expiratory pressure/exhalation valve also directly affects the level of airway pressure during spontaneous inhalation with CPAP (the greater the resistance of the valve, the greater the decrease in airway pressure and work of breathing). We compared this effect with three types of expiratory pressure valves: a threshold resistor with low resistance to flow, an inflatable balloon (mushroom) valve with moderate resistance to flow, and a variable-orifice flow resistor with a high resistance to flow. Work increased up to threefold with the balloon valve and more than tenfold with the flow resistor compared with the threshold resistor. To apply CPAP, expiratory pressure valves with low resistance to flow should be used to minimize fluctuations in airway pressure and, thus, in the work of spontaneous breathing.

journal_name

Chest

journal_title

Chest

authors

Banner MJ,Downs JB,Kirby RR,Smith RA,Boysen PG,Lampotang S

doi

10.1378/chest.93.4.795

subject

Has Abstract

pub_date

1988-04-01 00:00:00

pages

795-9

issue

4

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(16)34543-3

journal_volume

93

pub_type

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