Evidence map›Paper›PMID 40065461›Full record

ArticleCritical care (London, England)2025

Individualized PEEP can improve both pulmonary hemodynamics and lung function in acute lung injury.

Mayson L A Sousa, Luca S Menga, Annia Schreiber, Mattia Docci, Fernando Vieira, Bhushan H Katira, Mariangela Pellegrini, Sebastian Dubo, Ghislaine Douflé, Eduardo L V Costa and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed
–field-weighted citation impact
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

16 citing papers in PubMed.

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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

13 authors.

Mayson L A SousaKeenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada. Mayson.Sousa@umanitoba.ca.
Luca S MengaKeenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.
Annia SchreiberKeenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.
Mattia DocciKeenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.
Fernando VieiraKeenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.
Bhushan H KatiraPediatric Critical Care Medicine, Department of Pediatrics, Washington University in St Louis, St Louis, USA.
Mariangela PellegriniAnesthesiology and Intensive Care Medicine, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Sebastian DuboDepartment of Physiotherapy, Universidad de Concepción, Concepción, Chile.
Ghislaine DoufléInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada.
Eduardo L V CostaPulmonary Division, University of Sao Paulo, Sao Paulo, Brazil.
Martin PostTranslational Medicine Program, Research Institute, Hospital for Sick Children, Toronto, Canada.
Marcelo B P AmatoPulmonary Division, University of Sao Paulo, Sao Paulo, Brazil.
Laurent BrochardKeenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.

Funding

CIHR PJT156336
6 · The paper itself

Abstract

rationaleThere are several approaches to select the optimal positive end-expiratory pressure (PEEP), resulting in different PEEP levels. The impact of different PEEP settings may extend beyond respiratory mechanics, affecting pulmonary hemodynamics.

objectivesTo compare PEEP levels obtained with three titration strategies-(i) highest respiratory system compliance (C

methodsExperimental studies in two porcine models of acute lung injury: (I) bilateral injury induced in both lungs, generating a highly recruitable model (n = 37); (II) asymmetrical injury, generating a poorly recruitable model (n = 13). In all experiments, a decremental PEEP titration was performed monitoring P MEASUREMENTS AND MAIN

resultsPEEP titration methods resulted in different levels of median optimal PEEP in bilateral lung injury: 14(12-14) cmH

conclusionsIn porcine models of acute lung injury with variable lung recruitability, both low and high levels of PEEP can impair pulmonary hemodynamics. Optimized ventilation and hemodynamics can be obtained simultaneously at PEEP levels individualized based on respiratory mechanics, especially by EIT and esophageal pressure.

Indexed as

Acute Lung InjuryHemodynamicsLungPositive-Pressure RespirationAnimalsDisease Models, AnimalElectric ImpedanceRespiratory Function TestsRespiratory MechanicsSwineAcute lung injuryMechanical ventilationPositive end-expiratory pressurePulmonary hemodynamicsPulmonary vascular resistance

Identifiers

PMID40065461
PMCPMC11892255

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LicenceCC BY
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Registered trials

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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.