Monitoring Respiratory Drive and Respiratory Muscle Unloading During Mechanical Ventilation

An important limitation with today’s ventilatory management strategies is that while the timing and magnitude of assist is known, it is not possible to determine clinically the amount of unloading and reduction in respiratory drive. Moreover there are no methods to reveal if the ventilator’s assist is delivered when the patient makes the inspiratory effort. To improve accuracy, new monitoring devices for determining respiratory drive and patient-ventilator synchrony are needed. Determination of respiratory drive using diaphragm electrical activity, especially in combination with esophageal pressures can readily help to determine the effect of assist delivery.