ReviewIntensive care medicine2020
Clinical strategies for implementing lung and diaphragm-protective ventilation: avoiding insufficient and excessive effort.
Review in Intensive 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 4 registered trials, which are not on this map. Cited by 95 papers, 4 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.
Dynamic Transpulmonary Pressure in Covid-19 Pneumonia: Effects of Positive Pressure, Inspired Oxygen Fraction and Decubitus
The Efficacy of P0.1-guided Sedation Protocol in Critically Ill Patients Receiving Invasive Mechanical Ventilation: A Randomized Controlled Trial
Noninvasive Assessment of Inspiratory Effort and Tidal Distension During Noninvasive Ventilation. The INSPIRE Study.
Diaphragmatic Physiology Similarity Index May Titrate HFNC Flow Setting: A Prospective Observational Study
Who cites it
95 citing papers in PubMed, 4 syntheses or guidelines pooled it, 224 citations in OpenAlex.
- Efficacy of inspiratory muscle training on weaning success in mechanically ventilated ICU patients: a systematic review and network meta-analysis of randomized controlled trials.BMC pulmonary medicine · 2026Pooled it
- Risk factors for diaphragmatic dysfunction in mechanically ventilated patients: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled 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
- Impact of CPAP and ventilator system resistance on respiratory effort in healthy volunteers.BMC pulmonary medicine · 2026Trial
- Transcutaneous Electrical Acupoint Stimulation (TEAS) Facilitates Postoperative Recovery in Day Lung Cancer Surgery: A Randomized Controlled Trial.Journal of pain research · 2025Trial
- Remimazolam besylate versus propofol for deep sedation in critically ill patients: a randomized pilot study.Critical care (London, England) · 2023Trial
- Transcutaneous electrical diaphragmatic stimulation in mechanically ventilated patients: a randomised study.Critical care (London, England) · 2023Trial
- Strategies for lung- and diaphragm-protective ventilation in acute hypoxemic respiratory failure: a physiological trial.Critical care (London, England) · 2022Trial
- Physiology-guided mechanical ventilation: Monitoring, proportional assist, and bounded automation.World journal of critical care medicine · 2026Review
- ARDS 60th anniversary: spontaneous breathing in ARDS.Intensive care medicine · 2026Article
- Flow Index Trajectories During Spontaneous Breathing Trials Are Associated With Extubation Failure: A Latent Class Trajectory Modeling Study.Clinical and translational science · 2026Article
- Impact of Frailty and Diaphragmatic Dysfunction on Outcomes in ARDS: Focusing on Perioperative Respiratory Management.The clinical respiratory journal · 2026Article
- "Ventilator-induced diaphragmatic dysfunction: pathophysiology, monitoring and advances in potential treatment and prevention." W. Fu, L. Guan, Q. LiuEuropean respiratory review : an official journal of the European Respiratory Society · 2026Article
- Are right-sided diaphragmatic parameters sufficient to accurately evaluate global diaphragmatic physiological function? Commentary on "diaphragm physiological similarity index (DPSI): a de novo speckle-tracking ultrasound metric for HFNC adjustment in acute respiratory failure".Critical care (London, England) · 2026Article
- ERS Congress 2025: highlights from the Respiratory Intensive Care Assembly.ERJ open research · 2026Article
- The contribution of mechanical ventilation to critical illness-associated diaphragm dysfunction: a critical appraisal.Critical care (London, England) · 2026Review
- Mapping lung stress to visualize spatial heterogeneity and occult ventilation-induced lung injury risk in acute respiratory distress syndrome.American journal of respiratory and critical care medicine · 2026Article
- Knowledge and practice of airway pressure release ventilation in patients with acute respiratory distress syndrome among ICU nurses and respiratory therapists in China: a multicenter cross-sectional survey.Frontiers in medicine · 2026Article
- The diaphragm-intercostal index for predicting weaning failure in mechanically ventilated patients: a prospective cohort study.Frontiers in medicine · 2026Article
35 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
14 authors at 10 institutions in 7 countries.
Funding
Abstract
Mechanical ventilation may have adverse effects on both the lung and the diaphragm. Injury to the lung is mediated by excessive mechanical stress and strain, whereas the diaphragm develops atrophy as a consequence of low respiratory effort and injury in case of excessive effort. The lung and diaphragm-protective mechanical ventilation approach aims to protect both organs simultaneously whenever possible. This review summarizes practical strategies for achieving lung and diaphragm-protective targets at the bedside, focusing on inspiratory and expiratory ventilator settings, monitoring of inspiratory effort or respiratory drive, management of dyssynchrony, and sedation considerations. A number of potential future adjunctive strategies including extracorporeal CO
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.