The authors demonstrate that the conditions for correct flow measurement are not fulfilled when a resistive flow transducer (Fleisch pneumotachograph, screen pneumotachograph etc.) is connected directly to the mouth or to the end of the endotracheal tube. This is because the composition, temperature and water content of the respiratory gas varies markedly within a respiratory cycle, the mechanically ventilated patient exhales with a huge expiratory initial peak flow, and laminar flow tends to switch over to turbulent flow in this system. Methods are proposed of continuously compensating the effects of changing gas composition, reducing expiratory peak flow without an increase in expiratory resistance, and preventing the occurrence of turbulent flow. The improvement of measuring accuracy to 2% makes the estimation of respiratory volumes more reliable. Secondly, the increased quality of primary data enables one to analyze these data in a more complex and sophisticated manner (N2-washout compartment analyses, VDS, investigation of complicated modes of ventilation such as IMV, etc.).
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