ArticleIntensive care medicine experimental2015
Lung anatomy, energy load, and ventilator-induced lung injury.
Article in Intensive care medicine experimental, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers.
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.
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Who cites it
55 citing papers in PubMed, 104 citations in OpenAlex.
- Bedside Assessment of PEEP-Induced Volume and Mechanical Power in Mechanically Ventilated Adults Without ARDS: A Post Hoc Analysis.Medical sciences (Basel, Switzerland) · 2026Article
- Estimation of Transpulmonary Driving Pressure, Strain, and Lung-Specific Elastance Using Volumetric Methods in Invasively Ventilated Children-A Feasibility Study.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2026Article
- Article
- Mechanical Power and Driving Pressure: Mechanisms of Lung Injury, Markers of Pathophysiology, or Therapeutic Targets?Journal of clinical medicine · 2025Article
- Toward optimal mechanical ventilation of the injured lung: the role of expiratory duration.Critical care (London, England) · 2025Review
- Developing A Data Pipeline to Quantify Ventilator Waveforms.medRxiv : the preprint server for health sciences · 2025Article
- Mechanical Power Is Associated With Mortality in Pressure-Controlled Ventilated Patients: A Dutch, Single-Center Cohort Study.Critical care explorations · 2024Article
- Impacts of initial ICU driving pressure on outcomes in acute hypoxemic respiratory failure: a MIMIC-IV database study.Scientific reports · 2024Article
- A machine-learning regional clustering approach to understand ventilator-induced lung injury: a proof-of-concept experimental study.Intensive care medicine experimental · 2024Article
- Effects of training flights of combat jet pilots on parameters of airway function, diffusing capacity and systemic oxidative stress, and their association with flight parameters.European journal of medical research · 2024Article
- Estimation of normal lung weight index in healthy female domestic pigs.Intensive care medicine experimental · 2024Article
- A long-lasting porcine model of ARDS caused by pneumonia and ventilator-induced lung injury.Critical care (London, England) · 2023Review
- Precision Medicine Using Simultaneous Monitoring and Assessment with Imaging and Biomarkers to Manage Mechanical Ventilation in ARDS.Intensive care research · 2023Review
- Screening gene signatures for clinical response subtypes of lung transplantation.Molecular genetics and genomics : MGG · 2022Article
- Imaging the acute respiratory distress syndrome: past, present and future.Intensive care medicine · 2022Review
- Examining lung mechanical strains as influenced by breathing volumes and rates using experimental digital image correlation.Respiratory research · 2022Article
- Reliable Estimates of Power Delivery During Mechanical Ventilation Utilizing Easily Obtained Bedside Parameters.Respiratory care · 2022Article
- Concepts of advanced therapeutic delivery systems for the management of remodeling and inflammation in airway diseases.Future medicinal chemistry · 2022Review
- Ventilation-Induced Lung Injury (VILI) in Neonates: Evidence-Based Concepts and Lung-Protective Strategies.Journal of clinical medicine · 2022Review
- Management of Intraoperative Mechanical Ventilation to Prevent Postoperative Complications after General Anesthesia: A Narrative Review.Journal of clinical medicine · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh tidal volume can cause ventilator-induced lung injury (VILI), but positive end-expiratory pressure (PEEP) is thought to be protective. We aimed to find the volumetric VILI threshold and see whether PEEP is protective per se or indirectly.
methodsIn 76 pigs (22 ± 2 kg), we examined the lower and upper limits (30.9-59.7 mL/kg) of inspiratory capacity by computed tomography (CT) scan at 45 cmH2O pressure. The pigs underwent a 54-h mechanical ventilation with a global strain ((tidal volume (dynamic) + PEEP volume (static))/functional residual capacity) from 0.45 to 5.56. The dynamic strain ranged from 18 to 100 % of global strain. Twenty-nine pigs were ventilated with end-inspiratory volumes below the lower limit of inspiratory capacity (group "Below"), 38 within (group "Within"), and 9 above (group "Above"). VILI was defined as death and/or increased lung weight.
results"Below" pigs did not develop VILI; "Within" pigs developed lung edema, and 52 % died before the end of the experiment. The amount of edema was significantly related to dynamic strain (edema 188-153 × dynamic strain, R (2) = 0.48, p < 0.0001). In the "Above" group, 66 % of the pigs rapidly died but lung weight did not increase significantly. In pigs ventilated with similar tidal volume adding PEEP significantly increased mortality.
conclusionsThe threshold for VILI is the lower limit of inspiratory capacity. Below this threshold, VILI does not occur. Within these limits, severe/lethal VILI occurs depending on the dynamic component. Above inspiratory capacity stress at rupture may occur. In healthy lungs, PEEP is protective only if associated with a reduced tidal volume; otherwise, it has no effect or is harmful.
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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.