• Steffen Wirth, Christofer Best, Johannes Spaeth, Josef Guttmann, and Stefan Schumann.
• Division of Experimental Anesthesiology, Department of Anesthesiology and Intensive Care Medicine, University Medical Center, Hugstetter Straße 55, Freiburg, Germany. Electronic address: steffen.wirth@uniklinik-freiburg.de.
• Respir Physiol Neurobiol. 2014 Oct 1; 202: 59-63.

AbstractRecently, we presented Flow Controlled Expiration (FLEX) as a new option for lung-protective ventilation. FLEX delays the expiratory volume decrease in the lungs without prolonging the duration of expiration. Most ventilated patients nowadays receive spontaneous breathing support. We investigated whether FLEX is tolerated by awake subjects. In 24 healthy subjects restrictive lung disease was simulated by bandaging the thorax. The subjects were asked to indicate the perceived discomfort of breathing at various levels of positive end expiratory pressure (PEEP=0, 3, 6 or 9 cmH2O) with and without FLEX. Breathing discomfort was not affected by FLEX (p=0.269), but higher PEEP increased breathing discomfort (p<0.001). Only in forced choice comparison a stronger FLEX condition was perceived as less comfortable (p<0.01) than a weaker one. We conclude that FLEX decreases the breathing comfort in healthy subjects to a lesser extent than PEEP. Therefore, FLEX might be used to support ventilation therapy in spontaneously breathing patients.Copyright © 2014 Elsevier B.V. All rights reserved.

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