ArticleCritical care medicine2020
Flow-Controlled Ventilation Attenuates Lung Injury in a Porcine Model of Acute Respiratory Distress Syndrome: A Preclinical Randomized Controlled Study.
Article in Critical care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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Who cites it
31 citing papers in PubMed, 69 citations in OpenAlex.
- Control of the expiratory flow in a lung model and in healthy volunteers with an adjustable flow regulator: a combined bench and randomized crossover study.Respiratory research · 2021Trial
- Article
- Flow-controlled One-lung Ventilation During Carinal Sleeve Reconstruction: Anaesthetic Management and Technical Feasibility.Turkish journal of anaesthesiology and reanimation · 2026Article
- Continuous-flow ventilation with VENTIJET in moderate ARDS: a pilot safety and feasibility study.Intensive care medicine experimental · 2026Article
- Validation of the Formulas for Mechanical Power in Children and Proposal of the Concept of "Effective Mechanical Power".Journal of clinical medicine · 2026Article
- Redefining mechanical ventilation in thoracic anesthesia: flow-controlled ventilation from bench to bedside-a narrative review.Frontiers in medicine · 2026Review
- Flow-controlled ventilation versus pressure-controlled ventilation in moderate to severe ARDS patients: a randomized crossover physiological study.Intensive care medicine experimental · 2025Article
- Current Approaches to Airway and Ventilation Strategies in Laryngotracheal Surgery: A Narrative Review.Medicina (Kaunas, Lithuania) · 2025Review
- Prolonged Flow-Controlled Ventilation in a Patient With ARDS and Multiple Trauma: A Case Report.Chest · 2025Article
- Design and development of an affordable multi-mode small animal ventilator.Scientific reports · 2025Article
- Rheological Theory Applied to Mechanical Ventilation in Acute Respiratory Distress Syndrome: A New Paradigm for Understanding and Preventing Ventilator-Induced Lung Injury.Journal of clinical medicine · 2025Review
- [Anesthesia in transoral robot-assisted surgery].Die Anaesthesiologie · 2025Review
- A self-regulated expiratory flow device for mechanical ventilation: a bench study.Intensive care medicine experimental · 2024Article
- Flow-controlled ventilation decreases mechanical power in postoperative ICU patients.Intensive care medicine experimental · 2024Article
- Individualised flow-controlled ventilation reduces applied mechanical power and improves ventilation efficiency in a porcine intra-abdominal hypertension model.Intensive care medicine experimental · 2024Article
- Understanding the mechanisms of ventilator-induced lung injury using animal models.Intensive care medicine experimental · 2023Review
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- Article
- A new perspective during laryngo-tracheal surgery: the use of an ultra-thin endotracheal tube (Tritube®) and flow-controlled ventilation-a retrospective case series and a review of the literature.Journal of anesthesia, analgesia and critical care · 2022Article
- Intracycle power distribution in a heterogeneous multi-compartmental mathematical model: possible links to strain and VILI.Intensive care medicine experimental · 2022Article
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesLung-protective ventilation for acute respiratory distress syndrome aims for providing sufficient oxygenation and carbon dioxide clearance, while limiting the harmful effects of mechanical ventilation. "Flow-controlled ventilation", providing a constant expiratory flow, has been suggested as a new lung-protective ventilation strategy. The aim of this study was to test whether flow-controlled ventilation attenuates lung injury in an animal model of acute respiratory distress syndrome.
designPreclinical, randomized controlled animal study.
settingAnimal research facility. SUBJECTS: Nineteen German landrace hybrid pigs.
interventionFlow-controlled ventilation (intervention group) or volume-controlled ventilation (control group) with identical tidal volume (7 mL/kg) and positive end-expiratory pressure (9 cm H2O) after inducing acute respiratory distress syndrome with oleic acid. MEASUREMENTS AND MAIN
resultsPaO2 and PaCO2, minute volume, tracheal pressure, lung aeration measured via CT, alveolar wall thickness, cell infiltration, and surfactant protein A concentration in bronchoalveolar lavage fluid. Five pigs were excluded leaving n equals to 7 for each group. Compared with control, flow-controlled ventilation elevated PaO2 (154 ± 21 vs 105 ± 9 torr; 20.5 ± 2.8 vs 14.0 ± 1.2 kPa; p = 0.035) and achieved comparable PaCO2 (57 ± 3 vs 54 ± 1 torr; 7.6 ± 0.4 vs 7.1 ± 0.1 kPa; p = 0.37) with a lower minute volume (6.4 ± 0.5 vs 8.7 ± 0.4 L/min; p < 0.001). Inspiratory plateau pressure was comparable in both groups (31 ± 2 vs 34 ± 2 cm H2O; p = 0.16). Flow-controlled ventilation increased normally aerated (24% ± 4% vs 10% ± 2%; p = 0.004) and decreased nonaerated lung volume (23% ± 6% vs 38% ± 5%; p = 0.033) in the dependent lung region. Alveolar walls were thinner (5.5 ± 0.1 vs 7.8 ± 0.2 µm; p < 0.0001), cell infiltration was lower (20 ± 2 vs 32 ± 2 n/field; p < 0.0001), and normalized surfactant protein A concentration was higher with flow-controlled ventilation (1.1 ± 0.04 vs 1.0 ± 0.03; p = 0.039).
conclusionsFlow-controlled ventilation enhances lung aeration in the dependent lung region and consequently improves gas exchange and attenuates lung injury. Control of the expiratory flow may provide a novel option for lung-protective ventilation.
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