Which of the following factors can lead to increased work of breathing?

Increased work of breathing occurs when a patient is struggling to ventilate effectively, which can be exacerbated by factors such as patient-ventilator dyssynchrony. This phenomenon arises when there is a mismatch between the patient's breathing efforts and the ventilator's timing or delivery of breath, leading to added respiratory muscle work. As a result, the patient may have to exert more effort in initiating breaths or overcoming the ventilator's settings, which increases their overall work of breathing.

In contrast, effective ventilator settings, correct patient positioning, and proper medication are all aimed at optimizing ventilation and reducing the workload on the respiratory muscles. Effective ventilator settings ensure that the ventilator supports the patient's efforts and adequately matches their needs. Correct positioning can enhance lung mechanics and promote better gas exchange, while proper medication, such as bronchodilators or sedatives, can help relax the airway and facilitate easier breathing. Therefore, while the other options contribute to improving respiratory function, patient-ventilator dyssynchrony distinctly increases the work of breathing due to its disruptive nature during mechanical ventilation.