ArticleRespiratory research2019
What links ventilator driving pressure with survival in the acute respiratory distress syndrome? A computational study.
Article in Respiratory research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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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
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Individualised positive end-expiratory pressure to minimise driving pressure and postoperative pulmonary complications in minimally invasive thoracic and abdominal surgery a systematic review and meta-analysis.British journal of anaesthesia · 2026Pooled it
- Computational tools for personalizing treatment of acute respiratory failure, from machine learning to digital twins: a narrative review.Critical care (London, England) · 2026Review
- Article
- Postoperative outcomes following anatomical lung resections in relation to intraoperative ventilation practices: a registry-based multicenter study.Frontiers in surgery · 2026Article
- Driving pressure in acute respiratory distress syndrome for developing a protective lung strategy: A systematic review.World journal of critical care medicine · 2025Article
- The development of a C5.0 machine learning model in a limited data set to predict early mortality in patients with ARDS undergoing an initial session of prone positioning.Intensive care medicine experimental · 2024Article
- Factors associated with decreased compliance after on-site extracorporeal membrane oxygenation cannulation for acute respiratory distress syndrome: A retrospective, observational cohort study.Journal of intensive medicine · 2024Article
- Investigating the Association Between Dynamic Driving Pressure and Mortality in COVID-19-Related Acute Respiratory Distress Syndrome: A Joint Modeling Approach Using Real-Time Continuously-Monitored Ventilation Data.Critical care explorations · 2024Article
- Changes in Driving Pressure vs Oxygenation as Predictor of Mortality in Moderate to Severe Acute Respiratory Distress Syndrome Patients Receiving Prone Position Ventilation.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Computational Simulation of Virtual Patients Reduces Dataset Bias and Improves Machine Learning-Based Detection of ARDS from Noisy Heterogeneous ICU Datasets.IEEE open journal of engineering in medicine and biology · 2024Article
- The Impact of Mechanical Energy Assessment on Mechanical Ventilation: A Comprehensive Review and Practical Application.Medical science monitor : international medical journal of experimental and clinical research · 2023Review
- Developing an Artificial Intelligence-Based Representation of a Virtual Patient Model for Real-Time Diagnosis of Acute Respiratory Distress Syndrome.Diagnostics (Basel, Switzerland) · 2023Article
- Mechanical power is associated with weaning outcome in critically ill mechanically ventilated patients.Scientific reports · 2022Article
- Reduced survival in patients requiring chest tubes with COVID-19 acute respiratory distress syndrome.JTCVS open · 2022Article
- Validation of at-the-bedside formulae for estimating ventilator driving pressure during airway pressure release ventilation using computer simulation.Respiratory research · 2022Article
- Examining lung mechanical strains as influenced by breathing volumes and rates using experimental digital image correlation.Respiratory research · 2022Article
- The Association between Mechanical Power and Mortality in Patients with Pneumonia Using Pressure-Targeted Ventilation.Diagnostics (Basel, Switzerland) · 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
- ECCOFrontiers in medicine · 2021Article
- In Silico Modeling of Coronavirus Disease 2019 Acute Respiratory Distress Syndrome: Pathophysiologic Insights and Potential Management Implications.Critical care explorations · 2020Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundRecent analyses of patient data in acute respiratory distress syndrome (ARDS) showed that a lower ventilator driving pressure was associated with reduced relative risk of mortality. These findings await full validation in prospective clinical trials.
methodsTo investigate the association between driving pressures and ventilator induced lung injury (VILI), we calibrated a high fidelity computational simulator of cardiopulmonary pathophysiology against a clinical dataset, capturing the responses to changes in mechanical ventilation of 25 adult ARDS patients. Each of these in silico patients was subjected to the same range of values of driving pressure and positive end expiratory pressure (PEEP) used in the previous analyses of clinical trial data. The resulting effects on several physiological variables and proposed indices of VILI were computed and compared with data relating ventilator settings with relative risk of death.
resultsThree VILI indices: dynamic strain, mechanical power and tidal recruitment, showed a strong correlation with the reported relative risk of death across all ranges of driving pressures and PEEP. Other variables, such as alveolar pressure, oxygen delivery and lung compliance, correlated poorly with the data on relative risk of death.
conclusionsOur results suggest a credible mechanistic explanation for the proposed association between driving pressure and relative risk of death. While dynamic strain and tidal recruitment are difficult to measure routinely in patients, the easily computed VILI indicator known as mechanical power also showed a strong correlation with mortality risk, highlighting its potential usefulness in designing more protective ventilation strategies for this patient group.
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