Breathing effort and work of breathing during mechanical ventilation

Relief of an excessive breathing workload is a primary objective of providing mechanical ventilatory support. Although optimal management and timely withdrawal of machine assistance often hinge on the assessment of the breathing effort, gauging the work of breathing often proves difficult and subjective at the bedside. This discussion reviews the determinants of the work of breathing in patients receiving mechanical ventilation and describes the methodology by which the force output of the patient's own ventilatory pump can be accurately determined and optimized.