Compliance (CL = ΔV ÷ ΔP)

Change in volume (Lung expansion) produced by per unit change in pressure(Work of Breathing)

• Denotes the Ease of Distensibility of the lung and chest wall

• Compliance is inverse of elasticity or elastic recoil

Low CL= Difficult lung expansion
(Stiff Lung)High WOB
1. Usually related to condition that
reduces FRC
2. Have a restrictive lung
defect,low lung volume,low minute
ventilation
3. May be compensated by
increased rate.
Eg.HMD
High CL= Incomplete exhalation (lack of elastic recoil of lung) &
CO2 elimination
1. Conditions that increases FRC.
2. Steep slope on P-V curve.
3. Have an obstructive lung defect, airflow obstruction,
incomplete exhalation, poor gas exchange. E.g. Emphysema
Lung

.
Airway Resistance

Resistance = Pressure change/ Flow

Airway Resistance = (PIP-PEEP) ÷ Flow

Change in pressure per unit change in flow of gases. Due to friction b/w gas and air conducting system
(Airways & ET tube)

• Airway resistance = inversely proportional to its radius raised to the 4th power.

• If airway lumen decreased half  the resistance/work of breathing 16 times

• Newborns and young infants have inherently smaller airways, are especially proneto increase in airway
resistance from inflamed tissues and secretions.

• Resistance is high in diseases with airway obstruction like MAS and BPD

• During IMV: Airway resistance varies directly with length of ET & inversely withinternal diameter of ET

• Cut ET short*, Use largest appropriate ET size, Suction regularly

∆P (PIP - PEEP) can be treated as WOB

In clinical settings, airway obstruction is one of most frequentcauses of increased WOBDecreased

AirflowDecreased Minute VentilationHypoventilation CO2 retention

Prolonged high resistanceHigh WOB Respiratory musclefatigueVentilatory Failure & Oxygenation

FailureAirway Resistance & Work of Breathing
Time constant

Time constant Tc = Cl × R = ∆V/∆P × ∆P/V

Time const.= Compliance × Resistance = TV / Flow

A pressure gradient between atmosphere and alveoli must be established to moveair into or out of the
alveoli.

Tc is the time taken for the transthoracic pressure change to be transmitted as thevolume change in the
lungs, i.e. the time it takes for airway pressure and volumechanges to equilibrate b/w the proximal
airway and the alveoli.

• For practical purposes, all pressure and volume delivery (inflation/ deflation) iscomplete (99%) after 5
Tc.

• Inspiratory Tc<< Expiratory Tc

• Patients with Decreased Compliance (Shorter Tc) ventilate with Smaller TV andFaster Rates to
minimize PIP

• In pts with increased resistance (Long Tc), a fast rate results in short Ti &TeInadequate Ti results in
lower TV, whereas insufficient Te results in inadvertentPEEP/ auto-PEEP/ intrinsic PEEP  best
ventilated with Slower rates and LargerTV.