ArticleAnesthesiology2021
Respiratory Drive in Patients with Sepsis and Septic Shock: Modulation by High-flow Nasal Cannula.
Article in Anesthesiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Physiological Effects of High-Flow Tracheal Oxygen in Tracheostomized Patients Weaning From Mechanical Ventilation.Respiratory care · 2024Pooled it
- Physiological Effects of High-Flow Nasal Oxygen Compared With Conventional Oxygen Therapy: A Randomized Trial in Postextubation Patients.Critical care medicine · 2026Trial
- Awake pronation with helmet CPAP in early COVID-19 ARDS patients: effects on respiratory effort and distribution of ventilation assessed by EIT.Internal and emergency medicine · 2024Trial
- Respiratory support with nasal high flow without supplemental oxygen in patients undergoing endoscopic retrograde cholangiopancreatography under moderate sedation: a prospective, randomized, single-center clinical trial.BMC anesthesiology · 2023Trial
- Machine learning-based risk prediction of 28-day mortality for sepsis patients with augmented renal clearance.Scientific reports · 2026Article
- Digital twins of acute hypoxemic respiratory failure and sepsis patients suggest potential benefits of bi-level high flow nasal cannula therapy.Intensive care medicine · 2026Article
- PD-L1Respiratory research · 2025Article
- Breathing and balance: Clinical insights and management strategies of respiratory acid-base disorders.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2025Review
- Advancing shock prediction: leveraging prior knowledge and self-controlled data for enhanced model accuracy and generalizability.BMC medical informatics and decision making · 2025Article
- Histone lactylation exacerbates acute lung injury in septic mice by promoting ferroptosis in pulmonary microvascular endothelial cells.Burns & trauma · 2025Article
- Hemodynamic homeostasis disequilibrium in critical illness.Frontiers in physiology · 2025Review
- Combining OJournal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2024Review
- Association between high-flow nasal cannula use and mortality in patients with sepsis-induced acute lung injury: a retrospective propensity score-matched cohort study.BMC pulmonary medicine · 2024Article
- Article
- Reply letter on "Physiological effects of high-flow nasal cannula oxygen therapy after extubation: a randomized crossover study".Annals of intensive care · 2024Article
- Personalized Noninvasive Respiratory Support in the Perioperative Setting: State of the Art and Future Perspectives.Journal of personalized medicine · 2023Review
- Physiological effects of high-flow nasal cannula oxygen therapy after extubation: a randomized crossover study.Annals of intensive care · 2023Article
- Hyperoxia in critically ill patients with sepsis and septic shock: a systematic review.Journal of anesthesia, analgesia and critical care · 2023Review
- Effects of an asymmetrical high flow nasal cannula interface in hypoxemic patients.Critical care (London, England) · 2023Article
- Clinical risk factors for increased respiratory drive in intubated hypoxemic patients.Critical care (London, England) · 2023Article
Corrections and comments
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Authors and funding
13 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExperimental and pilot clinical data suggest that spontaneously breathing patients with sepsis and septic shock may present increased respiratory drive and effort, even in the absence of pulmonary infection. The study hypothesis was that respiratory drive and effort may be increased in septic patients and correlated with extrapulmonary determinant and that high-flow nasal cannula may modulate drive and effort.
methodsTwenty-five nonintubated patients with extrapulmonary sepsis or septic shock were enrolled. Each patient underwent three consecutive steps: low-flow oxygen at baseline, high-flow nasal cannula, and then low-flow oxygen again. Arterial blood gases, esophageal pressure, and electrical impedance tomography data were recorded toward the end of each step. Respiratory effort was measured as the negative swing of esophageal pressure (ΔPes); drive was quantified as the change in esophageal pressure during the first 500 ms from start of inspiration (P0.5). Dynamic lung compliance was calculated as the tidal volume measured by electrical impedance tomography, divided by ΔPes. The results are presented as medians [25th to 75th percentile].
resultsThirteen patients (52%) were in septic shock. The Sequential Organ Failure Assessment score was 5 [4 to 9]. During low-flow oxygen at baseline, respiratory drive and effort were elevated and significantly correlated with arterial lactate (r = 0.46, P = 0.034) and inversely with dynamic lung compliance (r = -0.735, P < 0.001). Noninvasive support by high-flow nasal cannula induced a significant decrease of respiratory drive (P0.5: 6.0 [4.4 to 9.0] vs. 4.3 [3.5 to 6.6] vs. 6.6 [4.9 to 10.7] cm H2O, P < 0.001) and effort (ΔPes: 8.0 [6.0 to 11.5] vs. 5.5 [4.5 to 8.0] vs. 7.5 [6.0 to 12.6] cm H2O, P < 0.001). Oxygenation and arterial carbon dioxide levels remained stable during all study phases.
conclusionsPatients with sepsis and septic shock of extrapulmonary origin present elevated respiratory drive and effort, which can be effectively reduced by high-flow nasal cannula. EDITOR’S PERSPECTIVE:
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