ArticleIntensive care medicine2016
Mortality and pulmonary mechanics in relation to respiratory system and transpulmonary driving pressures in ARDS.
Article in Intensive care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06433076 (The Association Between Respiratory Effort Parameters During the First 48 Hours With Clinical Outcomes in Mechanically Ventilated Patients), which is not on this map. Cited by 60 papers, 1 of them a synthesis 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.
The Association Between Respiratory Effort Parameters During the First 48 Hours With Clinical Outcomes in Mechanically Ventilated Patients: A Prospective Observational Study.
Who cites it
60 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effect of driving pressure-guided positive end-expiratory pressure on respiratory mechanics and clinical outcomes in surgical patients: a systematic review and meta-analysis of randomized controlled trials.Annals of medicine · 2025Pooled it
- The Effect of Transpulmonary Pressure-Guided Positive End-Expiratory Pressure Titration on Pulmonary Arterial Compliance in Acute Respiratory Distress Syndrome Patients: A Single-Center, Randomized Controlled Pilot Pathophysiological Study.Critical care explorations · 2026Trial
- Transpulmonary Pressure as a Predictor of Successful Lung Recruitment: Reanalysis of a Multicenter International Randomized Clinical Trial.Respiratory care · 2025Trial
- Trial
- Pulmonary Mechanics and Mortality in Mechanically Ventilated Patients Without Acute Respiratory Distress Syndrome: A Cohort Study.Shock (Augusta, Ga.) · 2018Trial
- Effect of driving pressure on mortality in ARDS patients during lung protective mechanical ventilation in two randomized controlled trials.Critical care (London, England) · 2016Trial
- Dissociation between airway and transpulmonary pressures during external chest wall restriction: a prospective self-controlled physiological study.Journal of thoracic disease · 2026Article
- Association of compliance-normalized airway and transpulmonary mechanical power with mortality in PARDS.European journal of pediatrics · 2026Observational
- Driving pressure in acute respiratory distress syndrome for developing a protective lung strategy: A systematic review.World journal of critical care medicine · 2025Article
- Article
- Estimation of the transpulmonary pressure from the central venous pressure in mechanically ventilated patients.Journal of clinical monitoring and computing · 2024Article
- Positive end-expiratory pressure optimization in ARDS: physiological evidence, bedside methods and clinical applications.Intensive care medicine · 2024Article
- Driving pressure of respiratory system and lung stress in mechanically ventilated patients with active breathing.Critical care (London, England) · 2024Observational
- Understanding the mechanisms of ventilator-induced lung injury using animal models.Intensive care medicine experimental · 2023Review
- The oesophageal balloon for respiratory monitoring in ventilated patients: updated clinical review and practical aspects.European respiratory review : an official journal of the European Respiratory Society · 2023Review
- Article
- The association of intraoperative low driving pressure ventilation and nonhome discharge: a historical cohort study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Article
- Setting the optimal positive end-expiratory pressure: a narrative review.Frontiers in veterinary science · 2023Review
- Association between intraoperative tidal volume and postoperative respiratory complications is dependent on respiratory elastance: a retrospective, multicentre cohort study.British journal of anaesthesia · 2022Article
- Development of a Pleural Pressure Catheter via Continuous Fiberoptic Esophageal Pressure Measurements.Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe driving pressure of the respiratory system has been shown to strongly correlate with mortality in a recent large retrospective ARDSnet study. Respiratory system driving pressure [plateau pressure-positive end-expiratory pressure (PEEP)] does not account for variable chest wall compliance. Esophageal manometry can be utilized to determine transpulmonary driving pressure. We have examined the relationships between respiratory system and transpulmonary driving pressure, pulmonary mechanics and 28-day mortality.
methodsFifty-six patients from a previous study were analyzed to compare PEEP titration to maintain positive transpulmonary end-expiratory pressure to a control protocol. Respiratory system and transpulmonary driving pressures and pulmonary mechanics were examined at baseline, 5 min and 24 h. Analysis of variance and linear regression were used to compare 28 day survivors versus non-survivors and the intervention group versus the control group, respectively.
resultsAt baseline and 5 min there was no difference in respiratory system or transpulmonary driving pressure. By 24 h, survivors had lower respiratory system and transpulmonary driving pressures. Similarly, by 24 h the intervention group had lower transpulmonary driving pressure. This decrease was explained by improved elastance and increased PEEP.
conclusionsThe results suggest that utilizing PEEP titration to target positive transpulmonary pressure via esophageal manometry causes both improved elastance and driving pressures. Treatment strategies leading to decreased respiratory system and transpulmonary driving pressure at 24 h may be associated with improved 28 day mortality. Studies to clarify the role of respiratory system and transpulmonary driving pressures as a prognosticator and bedside ventilator target are warranted.
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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.