ArticleAnnals of intensive care2021
High risk of patient self-inflicted lung injury in COVID-19 with frequently encountered spontaneous breathing patterns: a computational modelling study.
Article in Annals of intensive care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
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Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 79 citations in OpenAlex.
- High-flow nasal oxygen therapy compared with conventional oxygen therapy in hospitalised patients with respiratory illness: a systematic review and meta-analysis.BMJ open respiratory research · 2024Pooled it
- Performance of the Ventilatory Ratio to Predict Intubation in Patients With COVID-19 Acute Respiratory Distress Syndrome.Critical care explorations · 2026Article
- 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
- Digital twins for chronic lung diseases.European respiratory review : an official journal of the European Respiratory Society · 2024Review
- Comparison of the risk of pneumothorax in COVID-19 and seasonal influenza.Scientific reports · 2024Article
- In-hospital mortality, comorbidities, and costs of one million mechanically ventilated patients in Germany: a nationwide observational study before, during, and after the COVID-19 pandemic.The Lancet regional health. Europe · 2024Article
- FOT Technique Applied for Monitoring of COVID-19 Pneumonia Reveals Small Airways Involvement.Diagnostics (Basel, Switzerland) · 2024Article
- Comparison between high-flow nasal oxygen (HFNO) alternated with non-invasive ventilation (NIV) and HFNO and NIV alone in patients with COVID-19: a retrospective cohort study.European journal of medical research · 2024Article
- Predictors of Mortality and Orotracheal Intubation in Patients with Pulmonary Barotrauma Due to COVID-19: An Italian Multicenter Observational Study during Two Years of the Pandemic.Journal of clinical medicine · 2024Article
- Effects of three spontaneous ventilation modes on respiratory drive and muscle effort in COVID-19 pneumonia patients.BMC pulmonary medicine · 2023Observational
- Factors Associated With Prolonged Ventilation in Patients Receiving Prone Positioning Protocol With Muscle Relaxants for Severe COVID-19 Pneumonia.Respiratory care · 2023Article
- Lessons Learned in Mechanical Ventilation/Oxygen Support in Coronavirus Disease 2019.Clinics in chest medicine · 2023Review
- Impact of COVID-19 on Sedation Requirements during Veno-Venous Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome.Journal of clinical medicine · 2023Article
- The role of ROX index-based intubation in COVID-19 pneumonia: a cross-sectional comparison and retrospective survival analysis.Acute and critical care · 2023Article
- Is COVID-19 different from other causes of acute respiratory distress syndrome?Journal of intensive medicine · 2023Review
- Lessons from COVID-19 in the management of acute respiratory failure.Breathe (Sheffield, England) · 2023Review
- Delayed mechanical ventilation with prolonged high-flow nasal cannula exposure time as a risk factor for mortality in acute respiratory distress syndrome due to SARS-CoV-2.Internal and emergency medicine · 2023Observational
- Early Patient-Triggered Pressure Support Breathing in Mechanically Ventilated Patients with COVID-19 May Be Associated with Lower Rates of Acute Kidney Injury.Journal of clinical medicine · 2023Article
- Bronchoscopic Endobronchial Valve Therapy for Persistent Air Leaks in COVID-19 Patients Requiring Veno-Venous Extracorporeal Membrane Oxygenation.Journal of clinical medicine · 2023Article
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundThere is on-going controversy regarding the potential for increased respiratory effort to generate patient self-inflicted lung injury (P-SILI) in spontaneously breathing patients with COVID-19 acute hypoxaemic respiratory failure. However, direct clinical evidence linking increased inspiratory effort to lung injury is scarce. We adapted a computational simulator of cardiopulmonary pathophysiology to quantify the mechanical forces that could lead to P-SILI at different levels of respiratory effort. In accordance with recent data, the simulator parameters were manually adjusted to generate a population of 10 patients that recapitulate clinical features exhibited by certain COVID-19 patients, i.e., severe hypoxaemia combined with relatively well-preserved lung mechanics, being treated with supplemental oxygen.
resultsSimulations were conducted at tidal volumes (VT) and respiratory rates (RR) of 7 ml/kg and 14 breaths/min (representing normal respiratory effort) and at VT/RR of 7/20, 7/30, 10/14, 10/20 and 10/30 ml/kg / breaths/min. While oxygenation improved with higher respiratory efforts, significant increases in multiple indicators of the potential for lung injury were observed at all higher VT/RR combinations tested. Pleural pressure swing increased from 12.0 ± 0.3 cmH
conclusionsOur results suggest that the forces generated by increased inspiratory effort commonly seen in COVID-19 acute hypoxaemic respiratory failure are comparable with those that have been associated with ventilator-induced lung injury during mechanical ventilation. Respiratory efforts in these patients should be carefully monitored and controlled to minimise the risk of lung injury.
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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.