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Respiratory Muscle Unloading during Mechanical Ventilation

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Intensive Care Medicine

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Abstract

Mechanical ventilation is aimed at unloading the respiratory muscles and maintaining adequate ventilation. Webster’s dictionary states that ‘unloading’ is “to remove or discharge a load”; however, the aim in mechanical ventilation may just be to reduce the load. Unloading can be complete, as with controlled ventilation where the ventilator assumes all work and the respiratory muscles are inactive, or partial, where the ventilator assumes a portion of the workload and the respiratory muscles are active and contribute to the work performed. The ‘load’ to the respiratory muscles can be quantified as the force (pressure) that is required to displace the respiratory system in order to generate flow and volume. In patients with respiratory failure, this load is usually increased due to abnormal respiratory mechanics and intrinsic positive end-expiratory pressure (PEEPi) [1]. Also in such patients, the force generating capacity can be severely reduced [2], and therefore, what may appear to be a ‘normal’ load may actually represent an increased relative load.

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Authors
  1. J. Beck
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  2. J. Spahija
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  3. C. Sinderby
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Editors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent MD, PhD, FCCM, FCCP (Head) (Head)

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Beck, J., Spahija, J., Sinderby, C. (2003). Respiratory Muscle Unloading during Mechanical Ventilation. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-5548-0_27

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  • DOI: https://doi.org/10.1007/978-1-4757-5548-0_27

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-5550-3

  • Online ISBN: 978-1-4757-5548-0

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