{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T08:11:01Z","timestamp":1788768661876,"version":"build-2803163510"},"reference-count":37,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respiratory Care"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>The work of breathing (WOB) quantifies the energy cost of ventilation. This tutorial explores the fundamental physiology of WOB, its measurement via the Campbell diagram, and its bedside clinical application. The diagram visually partitions WOB into elastic (lung and chest wall) and resistive components, offering a physiological phenotype of respiratory failure. We describe how pathologies like ARDS and COPD alter the load\u2013capacity balance: reduced compliance drastically increases elastic work (flattening the pressure\u2013volume loop), while air flow obstruction increases resistive work (widening the loop). The tutorial further details the identification of intrinsic PEEP as a threshold load and the detection of specific patient\u2013ventilator asynchronies. Practical considerations, including esophageal balloon positioning and signal validation via the Baydur maneuver, are addressed to ensure accuracy. Although its use requires invasive measurements, the Campbell diagram remains the accepted\u00a0standard for assessing WOB. Mastering its interpretation allows clinicians to move beyond generic protocols, utilizing precise physiological data to tailor mechanical ventilation and optimize weaning strategies.<\/jats:p>","DOI":"10.1177\/19433654261453096","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T15:39:19Z","timestamp":1783438759000},"page":"1047-1054","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Work of Breathing by the Campbell Diagram: Physiology and Practice"],"prefix":"10.1177","volume":"71","author":[{"given":"Juan Martin","family":"Nu\u00f1ez Silveira","sequence":"first","affiliation":[{"name":"Mr. Nu\u00f1ez Silveira and Bramardi are affiliated with Department of Critical Care, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Gallardo","sequence":"additional","affiliation":[{"name":"Mr. Gallardo is affiliated with Servicio de Kinesiolog\u00eda, Sanatorio Cl\u00ednica Modelo de Mor\u00f3n, Mor\u00f3n, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glasiele","family":"Alcala","sequence":"additional","affiliation":[{"name":"Dr. Alcala is affiliated with Department of Anesthesia, Critical Care, and Pain Medicine, Anesthesia Center for Critical Care Research, Massachusetts General Hospital, Boston, Massachusetts, USA."},{"name":"Dr. Alcala is affiliated with Department of Anesthesia, Critical Care, and Pain Medicine, Anesthesia Center for Critical Care Research, Harvard Medical School, Boston, Massachusetts, USA."},{"name":"Dr. Alcala is affiliated with Divis\u00e3o de Pneumologia, Faculdade de Medicina, Instituto do Cora\u00e7\u00e3o, Hospital das Cl\u00ednicas HCFMUSP, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brasil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9404-7059","authenticated-orcid":false,"given":"Santiago","family":"Bramardi","sequence":"additional","affiliation":[{"name":"Mr. Nu\u00f1ez Silveira and Bramardi are affiliated with Department of Critical Care, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rutger","family":"Flink","sequence":"additional","affiliation":[{"name":"Dr. Flink is affiliated with PulmoTech, Leek, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemijn","family":"Jonkman","sequence":"additional","affiliation":[{"name":"Dr. Jonkman is affiliated with Department of Intensive Care, Erasmus Medical Center, Rotterdam, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001989"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1993.75.6.2506"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01712327"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-006-0278-3"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199403000-00024"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-008-1095-7"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0000000000000683"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.10225"},{"key":"e_1_3_2_10_1","first-page":"323","volume-title":"Handbook of Physiology. 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