ArticleAnnals of intensive care2016
End-inspiratory pause prolongation in acute respiratory distress syndrome patients: effects on gas exchange and mechanics.
Article in Annals of intensive care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 12 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.
Influence of the End-inspiratory Pause on Mechanical Ventilation and Its Correlation With Electrical Impedance Tomography
Clinical and Physiological Assessment of a Nearly Ultra-protective Lung Ventilation Strategy: A Quasi-experimental Preliminary Study in ARDS Patients
Respiratory System Mechanics and Gas Exchange Characteristics Applying Different Ventilatory Strategies in Patients With SARS-CoV-2
Influence of Inspiratory Pause on Ventilatory Efficiency and Tidal Volume Distribution in Patients Undergoing Robotic Prostate Surgery and Ventilated With an Individualized Open Lung Approach. A Prospective Paired Study.
Effects of Low Tidal Volume and Respiratory Rate Together With the Use of End-inspiratory on Alveolar Ventilation in ARDS Patients
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The role of acute hypercapnia on mortality and short-term physiology in patients mechanically ventilated for ARDS: a systematic review and meta-analysis.Intensive care medicine · 2022Pooled it
- End-inspiratory pause enhances ventilation efficiency without increasing autoPEEP in patients with COPD during controlled ventilation.Critical care (London, England) · 2026Trial
- Influence of the end inspiratory pause on ventilatory efficiency and respiratory mechanics in patients undergoing robotic surgery under a tailored open lung approach: a prospective-paired study.Anaesthesiology intensive therapy · 2025Article
- Lung morphology impacts the association between ventilatory variables and mortality in patients with acute respiratory distress syndrome.Critical care (London, England) · 2023Article
- Open the lungs, keep them open and… take a break?Anaesthesia, critical care & pain medicine · 2022Article
- A simple method of mechanical power calculation: using mean airway pressure to replace plateau pressure.Journal of clinical monitoring and computing · 2021Article
- Observational
- Management of hypercapnia in critically ill mechanically ventilated patients-A narrative review of literature.Journal of the Intensive Care Society · 2020Review
- Lung aeration in experimental malaria-associated acute respiratory distress syndrome by SPECT/CT analysis.PloS one · 2020Article
- Dead space in acute respiratory distress syndrome.Annals of translational medicine · 2018Review
- Fifty Years of Research in ARDS. Vt Selection in Acute Respiratory Distress Syndrome.American journal of respiratory and critical care medicine · 2017Review
- Hypercapnia during acute respiratory distress syndrome: the tree that hides the forest!Journal of thoracic disease · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnd-inspiratory pause (EIP) prolongation decreases dead space-to-tidal volume ratio (Vd/Vt) and PaCO2. We do not know the physiological benefits of this approach to improve respiratory system mechanics in acute respiratory distress syndrome (ARDS) patients when mild hypercapnia is of no concern.
methodsThe investigation was conducted in an intensive care unit of a university hospital, and 13 ARDS patients were included. The study was designed in three phases. First phase, baseline measurements were taken. Second phase, the EIP was prolonged until one of the following was achieved: (1) EIP of 0.7 s; (2) intrinsic positive end-expiratory pressure ≥1 cmH2O; or (3) inspiratory-expiratory ratio 1:1. Third phase, the Vt was decreased (30 mL every 30 min) until PaCO2 equal to baseline was reached. FiO2, PEEP, airflow and respiratory rate were kept constant.
resultsEIP was prolonged from 0.12 ± 0.04 to 0.7 s in all patients. This decreased the Vd/Vt and PaCO2 (0.70 ± 0.07 to 0.64 ± 0.08, p < 0.001 and 54 ± 9 to 50 ± 8 mmHg, p = 0.001, respectively). In the third phase, the decrease in Vt (from 6.3 ± 0.8 to 5.6 ± 0.8 mL/Kg PBW, p < 0.001) allowed to decrease plateau pressure and driving pressure (24 ± 3 to 22 ± 3 cmH2O, p < 0.001 and 13.4 ± 3.6 to 10.9 ± 3.1 cmH2O, p < 0.001, respectively) and increased respiratory system compliance from 29 ± 9 to 32 ± 11 mL/cmH2O (p = 0.001). PaO2 did not significantly change.
conclusionsProlonging EIP allowed a significant decrease in Vt without changes in PaCO2 in passively ventilated ARDS patients. This produced a significant decrease in plateau pressure and driving pressure and significantly increased respiratory system compliance, which suggests less overdistension and less dynamic strain.
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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.