Evidence map›Paper›PMID 35473715›Full record

ArticleRespiratory research2022

Validation of at-the-bedside formulae for estimating ventilator driving pressure during airway pressure release ventilation using computer simulation.

Sonal Mistry, Anup Das, Sina Saffaran, Nadir Yehya, Timothy E Scott, Marc Chikhani, John G Laffey, Jonathan G Hardman, Luigi Camporota, Declan G Bates

Open access · goldAbstract read
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In one paragraph

Article in Respiratory research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.3field-weighted citation impact, top 43% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 3 countries.

Sonal MistrySchool of Engineering, University of Warwick, Coventry, CV4 7AL, UK.
Anup DasSchool of Engineering, University of Warwick, Coventry, CV4 7AL, UK.
Sina SaffaranFaculty of Engineering Science, University College London, London, WC1E 6BT, UK.
Nadir YehyaDepartment of Anaesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA.
Timothy E ScottAcademic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, ICT Centre, Birmingham, B15 2SQ, UK.
Marc ChikhaniNottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK.
John G LaffeyAnaesthesia and Intensive Care Medicine, School of Medicine, NUI Galway, Galway, Ireland.
Jonathan G HardmanNottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK.
Luigi CamporotaDepartment of Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, UK. luigi.camporota@gstt.nhs.uk.
Declan G BatesSchool of Engineering, University of Warwick, Coventry, CV4 7AL, UK. d.bates@warwick.ac.uk.
University of Warwick · GBGuy's and St Thomas' NHS Foundation Trust · GBNottingham University Hospitals NHS Trust · GBOllscoil na Gaillimhe – University of Galway · IEPhiladelphia University · USUniversity College London · GBUniversity of Nottingham · GB

Funding

EPSRC EP/P023444/1
6 · The paper itself

Abstract

backgroundAirway pressure release ventilation (APRV) is widely available on mechanical ventilators and has been proposed as an early intervention to prevent lung injury or as a rescue therapy in the management of refractory hypoxemia. Driving pressure ([Formula: see text]) has been identified in numerous studies as a key indicator of ventilator-induced-lung-injury that needs to be carefully controlled. [Formula: see text] delivered by the ventilator in APRV is not directly measurable in dynamic conditions, and there is no "gold standard" method for its estimation.

methodsWe used a computational simulator matched to data from 90 patients with acute respiratory distress syndrome (ARDS) to evaluate the accuracy of three "at-the-bedside" methods for estimating ventilator [Formula: see text] during APRV.

resultsLevels of [Formula: see text] delivered by the ventilator in APRV were generally within safe limits, but in some cases exceeded levels specified by protective ventilation strategies. A formula based on estimating the intrinsic positive end expiratory pressure present at the end of the APRV release provided the most accurate estimates of [Formula: see text]. A second formula based on assuming that expiratory flow, volume and pressure decay mono-exponentially, and a third method that requires temporarily switching to volume-controlled ventilation, also provided accurate estimates of true [Formula: see text].

conclusionsLevels of [Formula: see text] delivered by the ventilator during APRV can potentially exceed levels specified by standard protective ventilation strategies, highlighting the need for careful monitoring. Our results show that [Formula: see text] delivered by the ventilator during APRV can be accurately estimated at the bedside using simple formulae that are based on readily available measurements.

Indexed as

Respiratory Distress SyndromeVentilator-Induced Lung InjuryComputer SimulationContinuous Positive Airway PressureHumansVentilators, MechanicalAcute respiratory distress syndromeAirway pressure release ventilationComputer simulationDriving pressureMechanical ventilationVentilator-induced lung injury

Identifiers

PMID35473715
PMCPMC9039982
OpenAlexW4224983171

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.