Trial reportCritical care (London, England)2023
Advanced respiratory mechanics assessment in mechanically ventilated obese and non-obese patients with or without acute respiratory distress syndrome.
Trial report in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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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.
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Who cites it
16 citing papers in PubMed, 28 citations in OpenAlex.
- Noninvasive ventilation in postoperative critically ill patients with morbid obesity: secondary analysis of the EXTUBOBESE multicentre randomised clinical trial.British journal of anaesthesia · 2025Trial
- Comparison of two transpulmonary pressure-based positive end-expiratory pressure titration strategies in acute respiratory distress syndrome: a randomized crossover study.Critical care (London, England) · 2025Trial
- Distribution of airway pressure opening in the lungs measured with electrical impedance tomography (POET): a prospective physiological study.Critical care (London, England) · 2025Trial
- ECMO for patients with obesity: evidence and practice.Intensive care medicine · 2026Review
- Obesity: biomechanical implications for mechanical ventilation.Critical care (London, England) · 2026Review
- Correspondence on "Mechanical ventilation for ICU patient with obesity: current best practices and future directions" Author's reply.Intensive care medicine · 2026Article
- Mechanical ventilation for ICU patients with obesity: current best practices and future directions.Intensive care medicine · 2026Article
- Mechanical ventilation for ICU patient with obesity: current best practices and future directions.Intensive care medicine · 2026Review
- Positive end-expiratory pressure optimisation during general anaesthesia in patients with obesity: a narrative review of respiratory and cardiovascular outcomes.British journal of anaesthesia · 2026Review
- Airway opening pressure in mechanically ventilated patients: regional distribution and impact of body position.Critical care (London, England) · 2025Article
- Respiratory effects of trunk inclination in obese and non-obese patients mechanically ventilated for ARDS.Critical care (London, England) · 2025Article
- Biomechanical implications of mass loading in a swine model of acute hypoxemic respiratory failure.Journal of applied physiology (Bethesda, Md. : 1985) · 2025Article
- Assessing fluid responsiveness by using functional hemodynamic tests in critically ill patients: a narrative review and a profile-based clinical guide.Journal of clinical monitoring and computing · 2025Review
- Evaluation of the success rate of the semi-sitting position compared with the supine position in the emergency intubation of traumatic patients.International journal of burns and trauma · 2025Article
- The pleural gradient does not reflect the superimposed pressure in patients with class III obesity.Critical care (London, England) · 2024Observational
- Airway opening pressure maneuver to detect airway closure in mechanically ventilated pediatric patients.Frontiers in pediatrics · 2024Article
Corrections and comments
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Authors and funding
16 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRespiratory mechanics is a key element to monitor mechanically ventilated patients and guide ventilator settings. Besides the usual basic assessments, some more complex explorations may allow to better characterize patients' respiratory mechanics and individualize ventilation strategies. These advanced respiratory mechanics assessments including esophageal pressure measurements and complete airway closure detection may be particularly relevant in critically ill obese patients. This study aimed to comprehensively assess respiratory mechanics in obese and non-obese ICU patients with or without ARDS and evaluate the contribution of advanced respiratory mechanics assessments compared to basic assessments in these patients.
methodsAll intubated patients admitted in two ICUs for any cause were prospectively included. Gas exchange and respiratory mechanics including esophageal pressure and end-expiratory lung volume (EELV) measurements and low-flow insufflation to detect complete airway closure were assessed in standardized conditions (tidal volume of 6 mL kg
resultsAmong the 149 analyzed patients, 52 (34.9%) were obese and 90 (60.4%) had ARDS (65.4% and 57.8% of obese and non-obese patients, respectively, p = 0.385). A complete airway closure was found in 23.5% of the patients. It was more frequent in obese than in non-obese patients (40.4% vs 14.4%, p < 0.001) and in ARDS than in non-ARDS patients (30% vs. 13.6%, p = 0.029). Respiratory system and lung compliances and EELV/PBW were similarly decreased in obese patients without ARDS and obese or non-obese patients with ARDS. Chest wall compliance was not impacted by obesity or ARDS, but end-expiratory esophageal pressure was higher in obese than in non-obese patients. Chest wall contribution to respiratory system compliance differed widely between patients but was not predictable by their general characteristics.
conclusionsMost respiratory mechanics features are similar in obese non-ARDS and non-obese ARDS patients, but end-expiratory esophageal pressure is higher in obese patients. A complete airway closure can be found in around 25% of critically ill patients ventilated with a PEEP of 5 cmH
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