ArticleAmerican journal of respiratory and critical care medicine2020
Lung- and Diaphragm-Protective Ventilation.
Article in American journal of respiratory and critical care medicine, 2020. 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 173 papers, 6 of them syntheses that pooled it.
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.
Estimation of the Diaphragm Electrical Activity and Intercostal Thickening Fraction During Different Pattern of Mechanical Ventilation: PSV Versus NAVA
Monitoring of Breathing Effort Through Pressure Time Product Measurement Using Airway Occlusion Pressure
Electrical Phrenic Nerve Stimulation in Patients With Ventilator-induced Diaphragm Dysfunction: a Randomized Controlled Study
Analysis of Advanced Physiological Ventilatory Parameters During Spontaneous Breathing Effort in Patients with Acute Hypoxemic Respiratory Failure
Impact of Positive End-Expiratory Pressure on the Modulation of Respiratory Effort During Assisted Ventilation: A Physiological Randomized Crossover Study
Who cites it
173 citing papers in PubMed, 6 syntheses or guidelines pooled it, 391 citations in OpenAlex.
- Acquisition of respiratory surface EMG: a systematic literature review of electrode configurations and methodological reporting.Critical care (London, England) · 2025Pooled it
- Physiological effects of noninvasive respiratory support strategies in adults with acute hypoxemic respiratory failure: a systematic review and network meta-analysis.Critical care (London, England) · 2025Pooled it
- Noninvasive monitoring of inspiratory effort in mechanical ventilation: a dual-database bibliometric analysis from 1990 to 2025.Frontiers in medicine · 2025Pooled it
- AARC Clinical Practice Guideline: Patient-Ventilator Assessment.Respiratory care · 2024Guideline
- An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome: An Official American Thoracic Society Clinical Practice Guideline.American journal of respiratory and critical care medicine · 2024Guideline
- Computational physiological models for individualised mechanical ventilation: a systematic literature review focussing on quality, availability, and clinical readiness.Critical care (London, England) · 2023Pooled it
- Physiological comparison of high-flow oxygen via endotracheal tube and T-piece strategies during spontaneous breathing trials: a randomized crossover study.Critical care (London, England) · 2026Trial
- Monitoring of breathing effort through pressure time product measurement using airway occlusion pressure (PTPBMC anesthesiology · 2026Trial
- Dexmedetomidine for sedation during noninvasive ventilation in COVID-19 patients from the Helmet-COVID randomized clinical trial post-hoc analysis.Scientific reports · 2026Trial
- Effects of external diaphragmatic pacing with neurally adjusted ventilatory assist on diaphragm function in AECOPD patients.Scientific reports · 2025Trial
- Comparison of programmed sedation care with conventional care in patients receiving mechanical ventilation for acute respiratory failure.Irish journal of medical science · 2025Trial
- Personalized positive end-expiratory pressure in spontaneously breathing patients with acute respiratory distress syndrome by simultaneous electrical impedance tomography and transpulmonary pressure monitoring: a randomized crossover trial.Intensive care medicine · 2024Trial
- Phenotypes based on respiratory drive and effort to identify the risk factors when P0.1 fails to estimate ∆PCritical care (London, England) · 2024Trial
- Pressure control plus spontaneous ventilation versus volume assist-control ventilation in acute respiratory distress syndrome. A randomised clinical trial.Intensive care medicine · 2024Trial
- Recruitment-to-inflation Ratio Assessed through Sequential End-expiratory Lung Volume Measurement in Acute Respiratory Distress Syndrome.Anesthesiology · 2023Trial
- Estimation of inspiratory effort using airway occlusion maneuvers in ventilated children: a secondary analysis of an ongoing randomized trial testing a lung and diaphragm protective ventilation strategy.Critical care (London, England) · 2023Trial
- Transcutaneous electrical diaphragmatic stimulation in mechanically ventilated patients: a randomised study.Critical care (London, England) · 2023Trial
- Physiological effects of awake prone position in acute hypoxemic respiratory failure.Critical care (London, England) · 2023Trial
- Respective Effects of Helmet Pressure Support, Continuous Positive Airway Pressure, and Nasal High-Flow in Hypoxemic Respiratory Failure: A Randomized Crossover Clinical Trial.American journal of respiratory and critical care medicine · 2023Trial
- Trial
113 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
31 authors at 20 institutions in 11 countries.
Funding
Abstract
Mechanical ventilation can cause acute diaphragm atrophy and injury, and this is associated with poor clinical outcomes. Although the importance and impact of lung-protective ventilation is widely appreciated and well established, the concept of diaphragm-protective ventilation has recently emerged as a potential complementary therapeutic strategy. This Perspective, developed from discussions at a meeting of international experts convened by PLUG (the Pleural Pressure Working Group) of the European Society of Intensive Care Medicine, outlines a conceptual framework for an integrated lung- and diaphragm-protective approach to mechanical ventilation on the basis of growing evidence about mechanisms of injury. We propose targets for diaphragm protection based on respiratory effort and patient-ventilator synchrony. The potential for conflict between diaphragm protection and lung protection under certain conditions is discussed; we emphasize that when conflicts arise, lung protection must be prioritized over diaphragm protection. Monitoring respiratory effort is essential to concomitantly protect both the diaphragm and the lung during mechanical ventilation. To implement lung- and diaphragm-protective ventilation, new approaches to monitoring, to setting the ventilator, and to titrating sedation will be required. Adjunctive interventions, including extracorporeal life support techniques, phrenic nerve stimulation, and clinical decision-support systems, may also play an important role in selected patients in the future. Evaluating the clinical impact of this new paradigm will be challenging, owing to the complexity of the intervention. The concept of lung- and diaphragm-protective ventilation presents a new opportunity to potentially improve clinical outcomes for critically ill patients.
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.