Noninvasive Method of Assessing Power of Breathing (POB) for Patients Receiving Pressure Support Ventilation

M.J. Banner PhD, N.R. Euliano PhD, P. Blanch RRT, A. Gabrielli MD
University of Florida, College of Medicine, Departments of Anesthesiology, and Physiology, and NeuroDimension, Inc., Gainesville, Florida, USA
* Study supported by a grant from the National Science Foundation

Introduction

A primary goal of mechanical ventilatory support is reduction of excessive work of breathing (WOB) per minute or POB. POB, the rate at which work of breathing is done, is a better assessment of respiratory muscle workloads than work of breathing because POB reflects the spontaneous inspiratory effort over time, not for an individual breath. Pressure support ventilation (PSV) is commonly used to assist spontaneous inhalation to maintain POB in a tolerable range (respiratory muscle load tolerance concept). Although appealing for directly assessing respiratory muscle workloads, measurement of POB on a routine basis is impractical due to the need to insert a balloon catheter to measure intraesophageal pressure (Pes). Other factors limiting the practicality of this approach are added equipment costs, and training to use these devices. We hypothesize that by using an artificial neural network (ANN) 5 with appropriate physiologic predictor variables, real-time POB data can be predicted accurately and noninvasively, without inserting a Pes catheter.