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It is of interest to note that future technical developments could enable the ventilator to generate the oscillation signal superimposed on the ventilation waveform [ 10, 20], which would considerably simplify the routine application of FOT.
optimal ventilation waveform.
A solution to this has been the design of a computer-driven optimal ventilation waveform (OVW) consisting of seven non-sum, non-difference sine waves with frequencies spanning from 0.156 to 8 Hz [18, 19, 50, 51].
We hypothesized that VILI can be reduced by modifying specific components of the ventilation waveform (mechanical breath), and we studied the impact of airway pressure release ventilation (APRV) and controlled mandatory ventilation (CMV) on the lung micro-anatomy (alveoli and conducting airways).
Forced oscillations at 5 Hz were superimposed on the ventilation waveform.
Bellardine et al. applied FOT using the enhanced ventilation waveform approach on an animal model of ARDS to study changes in lung mechanics at different PEEP levels [ 18].
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Recently, de Wit and colleagues [ 12] showed that, in patients with a high incidence of ineffective triggering (> 10% of all breaths) (as derived from ventilator waveform tracings), duration of mechanical ventilation is significantly longer compared with patients with a lower incidence of ineffective triggering.
We have previously published a highly specific and sensitive novel method to detect endotracheal intubation based on differences in ventilation pressure waveforms in the oesophagus and in the trachea in patients with healthy lungs [ 1].
With the setting shown in Fig. 1, the forced oscillation pressure can be superimposed on the ventilator pressure waveform without modifying or interfering with the ventilation protocol.
During all three modes of ventilation, the EAdi waveform was simultaneously recorded with flow and airway pressure from the respective ventilator (see Additional file 1).
Data collected included ventilation parameters, use of waveform capnography, Selective oral decontamination and patient position.
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