A Device to Provide Respiratory-Mechanical Unloading

A commercially available and widely used servo-controlled ventilator has been modified to provide controlled inspiratory resistive unloading of the human respiratory system. This is achieved by establishing a positive mouth pressure throughout inspiration in a constant proportion to instantaneous flow, i.e., the ratio of mouth pressure to flow, which defines the "assistance," remaining constant. The performance of this device has been evaluated in four healthy subjects during steady-state, constant-load cycling (20-120 W). It is demonstrated that i) the device can successfully implement controlled degrees of inspiratory assistance on a breath-to-breath basis; ii) the assistance can be sustained over a substantial range of ventilatory drive (i.e., for ventilations up to some 30 1/min) and to an extent which approaches a 100 percent reduction of the normal respiratory resistance. This device should prove useful in experimental and clinical investigations of the respiratory responses to resistive unloading of the respiratory system.