ArticleProceedings of the National Academy of Sciences of the United States of America2025
Mechanical ventilation energy analysis: Recruitment focuses injurious power in the ventilated lung.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Digital twins to analyse lung injury indices produced by a new protocol for transitioning to airway pressure release ventilation.Intensive care medicine · 2026Article
- Determinants of tidal recruitment/derecruitment assessed by electrical impedance tomography in spontaneously breathing acute respiratory distress syndrome patients.American journal of respiratory and critical care medicine · 2026Article
- From force to fate: Implications of mechanomemory in lung disease.Respiratory research · 2026Review
- Regional Alveolar Damage Despite Lung Protective Ventilation Settings During Robotic-Assisted Laparoscopic Surgery.Anesthesia and analgesia · 2026Article
- Injury Mechanics in Surfactant-Depleted and Healthy Rat Lungs: A Multi-scale Consideration of Artificial and Physiological Ventilation.Annals of biomedical engineering · 2026Article
- Deconstructing the Role of Mechanical Power in Lung Injury and Respiratory Failure.Anesthesiology · 2026Article
- 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
- Human ex-vivo lung mechanics differ under positive- and negative-pressure ventilation.Respiratory research · 2026Article
- Global mechanical power does not determine regional energy distribution in heterogeneous lungs.Frontiers in physiology · 2026Article
- Expert recommendations for setting and adjusting airway pressure release ventilation based on clinical experience and basic science evidence.Frontiers in medicine · 2026Article
- Physiology-guided personalized mechanical ventilation to prevent ventilator-induced lung injury.Frontiers in medicine · 2026Review
- The association of frailty and mechanical power with hospital mortality in critically ill patients: a retrospective study based on the MIMIC-IV and eICU database.European journal of medical research · 2025Article
- Mechanical Power and Driving Pressure: Mechanisms of Lung Injury, Markers of Pathophysiology, or Therapeutic Targets?Journal of clinical medicine · 2025Article
- Toward optimal mechanical ventilation of the injured lung: the role of expiratory duration.Critical care (London, England) · 2025Review
- Predictions of Atelectasis-Induced Microvolutrauma: A Key Pathway to Ventilator-Induced Lung Injury.Journal of biomechanical engineering · 2025Article
- Computationally-directed mechanical ventilation in a porcine model of ARDS.Frontiers in physiology · 2025Article
- Functional residual capacity and elastic power as prognostic markers in acute respiratory distress syndrome.American journal of translational research · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
The progression of acute respiratory distress syndrome (ARDS) from its onset due to disease or trauma to either recovery or death is poorly understood. Currently, there are no generally accepted treatments aside from supportive care using mechanical ventilation. However, this can lead to ventilator-induced lung injury (VILI), which contributes to a 30 to 40% mortality rate. In this study, we develop and demonstrate a technique to quantify forms of energy transport and dissipation during mechanical ventilation to directly evaluate their relationship to VILI. A porcine ARDS model was used, with ventilation parameters independently controlling lung overdistension and alveolar/airway recruitment/derecruitment (RD). Hourly measurements of airflow, tracheal and esophageal pressures, respiratory system impedance, and oxygen transport were taken for six hours following lung injury to track energy transfer and lung function. The final degree of injury was assessed histologically. Total and dissipated energies were quantified from lung pressure-volume relationships and subdivided into contributions from airflow, tissue viscoelasticity, and RD. Only RD correlated with physiologic recovery. Despite accounting for a very small fraction (2 to 5%) of the total energy dissipation, RD is damaging because it occurs quickly over a very small area. We estimate power intensity of RD energy dissipation to be 100 W/m
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