REVIEW   

Minerva Pneumologica 2019 September;58(3):91-6

DOI: 10.23736/S0026-4954.19.01853-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Physical mechanisms and features of the inspiratory work of breathing and the development of respiratory failure on a mechanical basis

Alessandro RUBINI ✉

Section of Physiology, Department of Biomedical Sciences, University of Padua, Padua, Italy

When the mechanical workload imposed to the inspiratory muscles is too high end long-lasting, muscles fatigue and respiratory failure on mechanical basis may ensue. This may happen if the elastic and/or resistive components of the inspiratory work of breathing are increased because of altered respiratory mechanics, which may occur in many respiratory diseases. Library data base (Pubmed, Scopus) were analyzed to search for papers dealing with the physical mechanisms and features of the inspiratory work of breathing, and the related development of respiratory failure on mechanical basis. Several experimental and clinical papers were found and results summarized in the text. As expected, a number of biochemical and biophysical conditions were described in the literature leading to increased work of breathing, thus potentially to respiratory failure. Among these, particularly relevant are common respiratory system diseases such as ARDS, COPD, lung fibrosis and asthma. Respiratory muscle fatigue represents a possible endpoint in patients suffering respiratory system diseases affecting respiratory mechanics, hence increasing the inspiratory work of breathing. This may force the physicians to adopt artificial mechanical ventilation.

KEY WORDS: Respiratory insufficiency; Respiratory mechanics; Work of breathing