Severe Work Shifting in Volume Control Mode

The following waveforms display volume control ventilation with a descending ramp pattern of inspiratory flow. All breaths are patient-triggered, as indicated by a pressure drop preceding inspiration. The pressure-time scalar shows a downward deflection below baseline, reflecting strong inspiratory efforts that generate negative intrathoracic pressure. This pattern suggests work shifting, where a significant portion of the breathing workload is transferred from the ventilator to patient. The expiratory flow-time scalar shows a rounded contour instead of a normal exponential decay indicating expiratory work.