Evidence map›Paper›PMID 40745324›Full record

ReviewCritical care (London, England)2025

Assessing inspiratory drive and effort in critically ill patients at the bedside.

Roberto Tonelli, Alessandro Protti, Elena Spinelli, Domenico Luca Grieco, Takeshi Yoshida, Annemijn H Jonkman, Evangelia Akoumianaki, Irene Telias, Mattia Docci, Antenor Rodrigues and 18 more

Abstract readReview
In one paragraph

Review 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 22 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 4 pooled it
–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

22 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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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

28 authors.

Roberto Tonelli *Respiratory Disease Unit, Department of Surgical and Medical Sciences of Motherhood and Child, University Hospital of Modena, Milan, Italy.
Alessandro Protti *Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. alessandro.protti@hunimed.eu.
Elena SpinelliDepartment of Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Domenico Luca GriecoDipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Takeshi YoshidaDepartment of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Annemijn H JonkmanDepartment of Intensive Care, Erasmus MC, Rotterdam, The Netherlands.
Evangelia AkoumianakiDepartment of Intensive Care, Medical School, University of Crete, Rethimno, Greece.
Irene TeliasKeenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada.
Mattia DocciKeenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada.
Antenor RodriguesKeenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada.
Joaquin PerezDepartment of Physical Therapy and Rehabilitation, Anchorena San Martín Clinic, Buenos Aires, Argentina.
Lise PiquilloudFaculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
Jeremy BeitlerASPIRE Trials Program, Division of Pulmonary, Critical Care, and Sleep Medicine, New York University, New York, USA.
Ling LiuJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, 210009, Nanjing, China.
Oriol RocaServei de Medicina Intensiva, Parc Taulí Hospital Universitari, Institut de Recerca Part Taulí (I3PT-CERCA), Sabadell, Spain.
Lara PisaniRespiratory and Critical Care Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy.
Ewan GoligherInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Guillaume CarteauxService de Médecine Intensive Réanimation, Groupe de Recherche Clinique CARMAS, Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, AP-HP, Créteil, France.
Giacomo BellaniCentre for Medical Sciences (CISMed), University of Trento, Trento, Italy.
Enrico CliniRespiratory Disease Unit, Department of Surgical and Medical Sciences of Motherhood and Child, University Hospital of Modena, Milan, Italy.
Jian-Xin ZhouEmergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Giacomo GrasselliDepartment of Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Samir JaberDepartment of Anesthesia and Intensive Care Unit, St-Eloi Hospital, Regional University Hospital of Montpellier, University of Montpellier,PhyMedExp, INSERM U1046, CNRS UMR, Montpellier, France.
Alexandre DemouleUMRS1158 Neurophysiologie Respiratoire Expérimentale Et Clinique, Sorbonne Université, INSERM, Paris, 75005, France.
Daniel TalmorDepartment of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Leo HeunksDepartment of intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands.
Laurent BrochardKeenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada.
Tommaso MauriDepartment of Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Monitoring inspiratory drive and effort may aid proper selection and setting of respiratory support in patients with acute respiratory failure (ARF), whether they are intubated or not. Although diaphragmatic electrical activity (EAdi) and esophageal manometry can be considered the reference methods for assessing respiratory drive and inspiratory effort, respectively, various alternative techniques exist, each with distinct advantages and limitations. This narrative review provides a comprehensive overview of bedside methods to assess respiratory drive and effort, with a primary focus on patients with ARF. First, EAdi and esophageal manometry are described and discussed as reference techniques. Then, alternative methods are categorized along the neuromechanical pathway from inspiratory drive to muscular effort into three groups: (1) techniques assessing the respiratory drive: airway occlusion pressure (P0.1), mean inspiratory flow (Vt/Ti) and respiratory muscle surface electromyography (sEMG); (2) techniques assessing the respiratory muscle effort: whole-breath occlusion pressure (ΔPocc), pressure-muscle index (PMI), nasal pressure swing (ΔPnose), diaphragm ultrasonography (USdi), central venous pressure swing (ΔCVP), breathing effort (BREF) models, and flow index; (3) techniques and clinical parameters assessing the consequences of effort: tidal volume (Vt), electrical impedance tomography (EIT), dyspnea. For each, we summarize the physiological rationale, measurement methodology, interpretation of results, and key limitations.

Indexed as

Critical IllnessWork of BreathingDiaphragmElectromyographyHumansManometryRespiratory InsufficiencyRespiratory MusclesAcute respiratory failureEsophageal pressureInspiratory effortPatient self-inflicted lung injuryRespiratory monitoringVentilator-induced diaphragm dysfunction.

Identifiers

PMID40745324
PMCPMC12315345

What OpenQuestion holds

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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.