Key messages

• Work of breathing can be calculated from measurements of airway pressure and volume in a patient receiving controlled mechanical ventilation (passive ventilation).

• In a patient who is assisting the ventilator, calculation of work of breathing requires measurement of airway pressure, esophageal pressure, and volume.

• Work of breathing can be partitioned into various components, such as pulmonary flow-resistive work, elastic work, and expiratory work.

• Accurate measurements of work of breathing are difficult to obtain, and there are several limitations to their calculation and interpretation.

• Patients who fail to wean from the ventilator exhibit increased values of work of breathing, but the usefulness of measuring work of breathing in predicting failure from weaning has not been evaluated prospectively.

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