ArticleIntensive care medicine experimental2021
Intracycle power and ventilation mode as potential contributors to ventilator-induced lung injury.
Article in Intensive care medicine experimental, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 28 citations in OpenAlex.
- The role of mechanical power in lung ventilation for the prevention of ventilator-induced lung injury: a narrative review.European respiratory review : an official journal of the European Respiratory Society · 2026Review
- Mechanical power of ventilation: tracking the damaging component.Critical care (London, England) · 2026Review
- Adjusting inspiratory rise time alters mechanical power in acute respiratory distress syndrome: opposing effects in pressure-controlled and volume-controlled ventilation modes.Frontiers in medicine · 2026Article
- Global mechanical power does not determine regional energy distribution in heterogeneous lungs.Frontiers in physiology · 2026Article
- Effect of Ventilator Settings on Mechanical Power During Simulated Mechanical Ventilation of Patients With ARDS.Respiratory care · 2024Article
- The effect of inspiratory rise time on mechanical power calculations in pressure control ventilation: dynamic approach.Intensive care medicine experimental · 2023Article
- Understanding the mechanisms of ventilator-induced lung injury using animal models.Intensive care medicine experimental · 2023Review
- Practical assessment of risk of VILI from ventilating power: a conceptual model.Critical care (London, England) · 2023Review
- Positive- and Negative-Pressure Ventilation Characterized by Local and Global Pulmonary Mechanics.American journal of respiratory and critical care medicine · 2023Article
- A prospective clinical study on the mechanisms underlying critical illness myopathy-A time-course approach.Journal of cachexia, sarcopenia and muscle · 2022Article
- What Is Different in Acute Hematologic Malignancy-Associated ARDS? An Overview of the Literature.Medicina (Kaunas, Lithuania) · 2022Review
- Intracycle power distribution in a heterogeneous multi-compartmental mathematical model: possible links to strain and VILI.Intensive care medicine experimental · 2022Article
- Outcomes and risk factors for delayed-onset postoperative respiratory failure: a multi-center case-control study by the University of California Critical Care Research Collaborative (UCBMC anesthesiology · 2022Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundHigh rates of inflation energy delivery coupled with transpulmonary tidal pressures of sufficient magnitude may augment the risk of damage to vulnerable, stress-focused units within a mechanically heterogeneous lung. Apart from flow amplitude, the clinician-selected flow waveform, a relatively neglected dimension of inflation power, may distribute inflation energy of each inflation cycle non-uniformly among alveoli with different mechanical properties over the domains of time and space. In this initial step in modeling intracycle power distribution, our primary objective was to develop a mathematical model of global intracycle inflation power that uses clinician-measurable inputs to allow comparisons of instantaneous ICP profiles among the flow modes commonly encountered in clinical practice: constant, linearly decelerating, exponentially decelerating (pressure control), and spontaneous (sinusoidal).
methodsWe first tested the predictions of our mathematical model of passive inflation with the actual physical performance of a mechanical ventilator-lung system that simulated ventilation to three types of patients: normal, severe ARDS, and severe airflow obstruction. After verification, model predictions were then generated for 5000 'virtual ARDS patients'. Holding constant the tidal volume and inflation time between modes, the validated model then varied the flow profile and quantitated the resulting intensity and timing of potentially damaging 'elastic' energy and intracycle power (pressure-flow product) developed in response to random combinations of machine settings and severity levels for ARDS.
resultsOur modeling indicates that while the varied flow patterns ultimately deliver similar total amounts of alveolar energy during each breath, they differ profoundly regarding the potentially damaging pattern with which that energy distributes over time during inflation. Pressure control imposed relatively high maximal intracycle power.
conclusionsFlow amplitude and waveform may be relatively neglected and modifiable determinants of VILI risk when ventilating ARDS.
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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.