Evidence map›Paper›PMID 38031116›Full record

Trial reportCritical care (London, England)2023

Estimation of inspiratory effort using airway occlusion maneuvers in ventilated children: a secondary analysis of an ongoing randomized trial testing a lung and diaphragm protective ventilation strategy.

Yukie Ito, Matías G Herrera, Justin C Hotz, Miyako Kyogoku, Christopher J L Newth, Anoopindar K Bhalla, Muneyuki Takeuchi, Robinder G Khemani

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

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. It is linked to trial NCT03266016 (Identifying and Preventing Ventilator Induced Diaphragm Dysfunction in Children), which is not on this map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
4.4field-weighted citation impact, top 5% 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.

NCT03266016 nacompletednot on this map

Identifying and Preventing Ventilator Induced Diaphragm Dysfunction in Children

TypeinterventionalSponsorChildren's Hospital Los AngelesRan2017 to 2024Enrolled248ConditionsVentilation Therapy, Complications, Diaphragm Disease, Pediatric Respiratory DiseasesArmsComputerized Ventilator Protocol, Esophageal Manometry, Respiratory Inductance Plethysmography (RIP), Diaphragm Ultrasound, Maximal Inspiratory Pressure
3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

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  4. Article
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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

8 authors at 4 institutions in 3 countries.

Yukie ItoDepartment of Intensive Care, Osaka Women's and Children's Hospital, Osaka, Japan.
Matías G HerreraDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, USA.
Justin C HotzDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, USA.
Miyako KyogokuDepartment of Intensive Care, Osaka Women's and Children's Hospital, Osaka, Japan.
Christopher J L NewthDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, USA.
Anoopindar K BhallaDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, USA.
Muneyuki TakeuchiDepartment of Intensive Care, Osaka Women's and Children's Hospital, Osaka, Japan.
Robinder G KhemaniDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, USA. RKhemani@chla.usc.edu.
Osaka Women's and Children's Hospital · JPChildren's Hospital of Los Angeles · USUniversity of Southern California · USGarrahan Hospital · AR

Funding

Pathobiologic profile and outcomes of critically ill children and adolescents exposed to vaping and e-cigarettesR01HL134666 · NHLBI · CHILDREN'S HOSPITAL OF LOS ANGELES · PI KHEMANI, ROBINDER · 2017 to 2021
$3.3M
NHLBI NIH HHS 1RO11HL134666-01NHLBI NIH HHS R01 HL134666
6 · The paper itself

Abstract

backgroundMonitoring respiratory effort in ventilated patients is important to balance lung and diaphragm protection. Esophageal manometry remains the gold standard for monitoring respiratory effort but is invasive and requires expertise for its measurement and interpretation. Airway pressures during occlusion maneuvers may provide an alternative, although pediatric data are limited. We sought to determine the correlation between change in esophageal pressure during tidal breathing (∆Pes) and airway pressure measured during three airway occlusion maneuvers: (1) expiratory occlusion pressure (Pocc), (2) airway occlusion pressure (P0.1), and (3) respiratory muscle pressure index (PMI) in children. We also sought to explore pediatric threshold values for these pressures to detect excessive or insufficient respiratory effort.

methodsSecondary analysis of physiologic data from children between 1 month and 18 years of age with acute respiratory distress syndrome enrolled in an ongoing randomized clinical trial testing a lung and diaphragm protective ventilation strategy (REDvent, R01HL124666). ∆Pes, Pocc, P0.1, and PMI were measured. Repeated measure correlations were used to investigate correlation coefficients between ∆Pes and the three measures, and linear regression equations were generated to identify potential therapeutic thresholds.

resultsThere were 653 inspiratory and 713 expiratory holds from 97 patients. Pocc had the strongest correlation with ∆Pes (r = 0.68), followed by PMI (r = 0.60) and P0.1 (r = 0.42). ∆Pes could be reliably estimated using the regression equation ∆Pes = 0.66 [Formula: see text] Pocc (R

conclusionsAirway occlusion maneuvers may be appropriate alternatives to esophageal pressure measurement to estimate the inspiratory effort in children, and Pocc represents the most promising target.

trial registrationNCT03266016; August 23, 2017.

Indexed as

DiaphragmRespirationAdolescentChildHumansInfantLungPositive-Pressure RespirationRespiration, ArtificialArtificial respirationMechanical ventilationMyotraumaVentilator-induced lung injuryWork of breathing

Identifiers

PMID38031116
PMCPMC10685539
OpenAlexW4389143119

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.