ArticleCritical care medicine2013
Lung stress and strain during mechanical ventilation: any difference between statics and dynamics?
Article in Critical care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 151 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Risk Assessment of Ventilator-induced Lung Injury in Patients With Acute Respiratory Distress Syndrome: The Role of Morphological Phenotype in ARDS
Evaluation of the Effect of Two Different Intra-abdominal Pressure Applications on "Mechanical Power" in Cases Undergoing Laparoscopic Cholecystectomy
Who cites it
151 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effects of individualized positive end-expiratory pressure combined with recruitment maneuver on intraoperative ventilation during abdominal surgery: a systematic review and network meta-analysis of randomized controlled trials.Journal of anesthesia · 2022Pooled it
- Effect of different levels of PEEP on mortality in ICU patients without acute respiratory distress syndrome: systematic review and meta-analysis with trial sequential analysis.Journal of critical care · 2021Pooled it
- Respiratory effects of recruitment maneuvers according to lung recruitability assessed by electrical impedance tomography in patients with acute respiratory distress syndrome.Journal of clinical monitoring and computing · 2026Trial
- Comparison of PEEP titration methods to improve respiratory system compliance in acute respiratory distress syndrome: a randomized controlled study.Critical care science · 2026Trial
- Effect of a driving pressure-limiting strategy for patients with acute respiratory distress syndrome secondary to community-acquired pneumonia: the STAMINA randomised clinical trial.British journal of anaesthesia · 2025Trial
- Effect of automated versus conventional ventilation on mechanical power of ventilation-A randomized crossover clinical trial.PloS one · 2024Trial
- Physiological effects of awake prone position in acute hypoxemic respiratory failure.Critical care (London, England) · 2023Trial
- Respective Effects of Helmet Pressure Support, Continuous Positive Airway Pressure, and Nasal High-Flow in Hypoxemic Respiratory Failure: A Randomized Crossover Clinical Trial.American journal of respiratory and critical care medicine · 2023Trial
- Low tidal volume ventilation for patients undergoing laparoscopic surgery: a secondary analysis of a randomised clinical trial.BMC anesthesiology · 2023Trial
- Multimodal non-invasive monitoring to apply an open lung approach strategy in morbidly obese patients during bariatric surgery.Journal of clinical monitoring and computing · 2020Trial
- The effects of low tidal ventilation on lung strain correlate with respiratory system compliance.Critical care (London, England) · 2017Trial
- Bedside assessment of the effects of positive end-expiratory pressure on lung inflation and recruitment by the helium dilution technique and electrical impedance tomography.Intensive care medicine · 2016Trial
- PEEP and alveolar recruitment after 60 years of acute respiratory distress syndrome.Intensive care medicine · 2026Review
- Lung- and diaphragm-protective mechanical ventilation in acute respiratory distress syndrome.Intensive care medicine · 2026Review
- ARDS management beyond the guidelines: a practical physiology-based approach to individualized care.Intensive care medicine · 2026Review
- Bedside Assessment of PEEP-Induced Volume and Mechanical Power in Mechanically Ventilated Adults Without ARDS: A Post Hoc Analysis.Medical sciences (Basel, Switzerland) · 2026Article
- Characterizing heterogeneity and subphenotyping acute respiratory distress syndrome with computed tomography.Intensive care medicine experimental · 2026Review
- Protective Ventilation During Controlled and Partial Ventilatory Support in ARDS: Clinical-Physiological Background and Monitoring.Journal of clinical medicine · 2026Review
- Positive end-expiratory pressure titration in acute respiratory distress syndrome-a practical bedside algorithm.Frontiers in medicine · 2026Review
- Expert recommendations for setting and adjusting airway pressure release ventilation based on clinical experience and basic science evidence.Frontiers in medicine · 2026Article
91 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTidal volume (VT) and volume of gas caused by positive end-expiratory pressure (VPEEP) generate dynamic and static lung strains, respectively. Our aim was to clarify whether different combinations of dynamic and static strains, resulting in the same large global strain, constantly produce lung edema.
designLaboratory investigation.
settingAnimal unit. SUBJECTS: Twenty-eight healthy pigs.
interventionsAfter lung computed tomography, 20 animals were ventilated for 54 hours at a global strain of 2.5, either entirely dynamic (VT 100% and VPEEP 0%), partly dynamic and partly static (VT 75-50% and VPEEP 25-50%), or mainly static (VT 25% and VPEEP 75%) and then killed. In eight other pigs (VT 25% and VPEEP 75%), VPEEP was abruptly zeroed after 36-54 hours and ventilation continued for 3 hours. MEASUREMENTS AND MAIN
resultsEdema was diagnosed when final lung weight (balance) exceeded the initial weight (computed tomography). Mortality, lung mechanics, gas exchange, pulmonary histology, and inflammation were evaluated. All animals ventilated with entirely dynamic strain (VT 825±424 mL) developed pulmonary edema (lung weight from 334±38 to 658±99 g, p<0.01), whereas none of those ventilated with mainly static strain (VT 237±21 mL and VPEEP 906±114 mL, corresponding to 19±1 cm H2O of positive end-expiratory pressure) did (from 314±55 to 277±46 g, p=0.65). Animals ventilated with intermediate combinations finally had normal or largely increased lung weight. Smaller dynamic and larger static strains lowered mortality (p<0.01), derangement of lung mechanics (p<0.01), and arterial oxygenation (p<0.01), histological injury score (p=0.03), and bronchoalveolar interleukin-6 concentration (p<0.01). Removal of positive end-expiratory pressure did not result in abrupt increase in lung weight (from 336±36 to 351±77 g, p=0.51).
conclusionsLung edema forms (possibly as an all-or-none response) depending not only on global strain but also on its components. Large static are less harmful than large dynamic strains, but not because the former merely counteracts fluid extravasation.
Indexed as
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.