ArticleCritical care (London, England)2024
Post-insufflation diaphragm contractions in patients receiving various modes of mechanical ventilation.
Article in Critical care (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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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.
The trial behind it
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Who cites it
4 citing papers in PubMed.
- Patient Self-Inflicted Lung Injury in ARDS: From Physiological Concept to Clinical Syndrome.Journal of clinical medicine · 2026Review
- Pattern of extra-diaphragmatic respiratory muscle activity during exercise in patients with unilateral diaphragm dysfunction.Physiological reports · 2025Article
- Assessing inspiratory drive and effort in critically ill patients at the bedside.Critical care (London, England) · 2025Review
- Timing of activation of different inspiratory muscles during incremental inspiratory loading in healthy adults: A cross-sectional study.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundDuring mechanical ventilation, post-insufflation diaphragm contractions (PIDCs) are non-physiologic and could be injurious. PIDCs could be frequent during reverse-triggering, where diaphragm contractions follow the ventilator rhythm. Whether PIDCs happens with different modes of assisted ventilation is unknown. In mechanically ventilated patients with hypoxemic respiratory failure, we aimed to examine whether PIDCs are associated with ventilator settings, patients' characteristics or both.
methodsOne-hour recordings of diaphragm electromyography (EAdi), airway pressure and flow were collected once per day for up to five days from intubation until full recovery of diaphragm activity or death. Each breath was classified as mandatory (without-reverse-triggering), reverse-triggering, or patient triggered. Reverse triggering was further subclassified according to EAdi timing relative to ventilator cycle or reverse triggering leading to breath-stacking. EAdi timing (onset, offset), peak and neural inspiratory time (Ti
resultsForty-seven patients (median[25%-75%IQR] age: 63[52-77] years, BMI: 24.9[22.9-33.7] kg/m
conclusionsIn critically ill mechanically ventilated patients, PIDCs and reverse triggering phenotypes were associated with potentially modifiable factors, including ventilator settings. Proportional modes like NAVA represent a solution abolishing PIDCs.
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