ArticleBritish journal of anaesthesia2016
High PEEP in acute respiratory distress syndrome: quantitative evaluation between improved arterial oxygenation and decreased oxygen delivery.
Article in British journal of anaesthesia, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04297397 (Personalised Simulation Technologies for Optimising Treatment in the Intensive Care Unit), which is not on this map. Cited by 24 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Personalised Simulation Technologies for Optimising Treatment in the Intensive Care Unit
Who cites it
24 citing papers in PubMed, 63 citations in OpenAlex.
- Comparative Analysis of 5 cmH₂O Versus 10 cmH₂O PEEP on Cerebral Oxygen Saturation in Brain Tumor Surgery: A Randomized Controlled Clinical Study.Medical science monitor : international medical journal of experimental and clinical research · 2025Trial
- Heart-lung interactions in ARDS: practical bedside implications.Intensive care medicine · 2026Article
- Computational tools for personalizing treatment of acute respiratory failure, from machine learning to digital twins: a narrative review.Critical care (London, England) · 2026Review
- Beyond One-Size-Fits-All: Precision Mechanical Ventilation in ARDS.Journal of clinical medicine · 2026Review
- Digital twins suggest a mechanistic basis for differing responses to increased flow rates during high-flow nasal cannula therapy.Intensive care medicine experimental · 2025Article
- Airway pressures generated by high flow nasal cannula in patients with acute hypoxemic respiratory failure: a computational study.Respiratory research · 2025Article
- Unveiling the Influence of AI on Advancements in Respiratory Care: Narrative Review.Interactive journal of medical research · 2024Review
- The Impact of Increased PEEP on Hemodynamics, Respiratory Mechanics, and Oxygenation in Pediatric ARDS.Respiratory care · 2024Article
- Digital twins for chronic lung diseases.European respiratory review : an official journal of the European Respiratory Society · 2024Review
- Imaging the Lung in ARDS: A Primer.Respiratory care · 2024Review
- Reinforcement learning for intensive care medicine: actionable clinical insights from novel approaches to reward shaping and off-policy model evaluation.Intensive care medicine experimental · 2024Article
- A systematic review of cardiacProgress in biomedical engineering (Bristol, England) · 2023Review
- Implementation of Early Rehabilitation in Severe COVID-19 Respiratory Failure: A Scoping Review.Journal of acute care physical therapy · 2023Article
- ARDS associated acute brain injury: from the lung to the brain.European journal of medical research · 2022Review
- Pathophysiology of Brain Injury and Neurological Outcome in Acute Respiratory Distress Syndrome: A Scoping Review of Preclinical to Clinical Studies.Neurocritical care · 2021Article
- High risk of patient self-inflicted lung injury in COVID-19 with frequently encountered spontaneous breathing patterns: a computational modelling study.Annals of intensive care · 2021Article
- Management of Intraoperative Mechanical Ventilation to Prevent Postoperative Complications after General Anesthesia: A Narrative Review.Journal of clinical medicine · 2021Review
- In Silico Modeling of Coronavirus Disease 2019 Acute Respiratory Distress Syndrome: Pathophysiologic Insights and Potential Management Implications.Critical care explorations · 2020Article
- Effect of oxygen fraction on airway rescue: a computational modelling study.British journal of anaesthesia · 2020Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPositive end-expiratory pressure (PEEP) is widely used to improve oxygenation and prevent alveolar collapse in mechanically ventilated patients with the acute respiratory distress syndrome (ARDS). Although PEEP improves arterial oxygenation predictably, high-PEEP strategies have demonstrated equivocal improvements in ARDS-related mortality. The effect of PEEP on tissue oxygen delivery is poorly understood and is difficult to quantify or investigate in the clinical environment.
methodsWe investigated the effects of PEEP on tissue oxygen delivery in ARDS using a new, high-fidelity, computational model with highly integrated respiratory and cardiovascular systems. The model was configured to replicate published clinical trial data on the responses of 12 individual ARDS patients to changes in PEEP. These virtual patients were subjected to increasing PEEP levels during a lung-protective ventilation strategy (0-20 cm H
resultsAs PEEP increased, tissue oxygen delivery decreased in all subjects (mean reduction of 25% at 20 cm H
conclusionsIncremental PEEP in ARDS appears to protect alveoli and improve arterial oxygenation, but also appears to impair tissue oxygen delivery significantly because of reduced cardiac output. We propose that this trade-off may explain the poor improvements in mortality associated with high-PEEP ventilation strategies.
Indexed as
Identifiers
What OpenQuestion holds
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.