Evidence map›Paper›PMID 41219816›Full record

Observational studyCritical care (London, England)2025

Association between controlled mechanical ventilation and systemic inflammation in acute hypoxemic respiratory failure: an observational cohort study.

M Consuelo Bachmann, Martín Benites, Vanessa Oviedo, Niki Hamidi Vadeghani, Dagoberto Soto, Roque Basoalto, Pablo Cruces, Yorschua Jalil, L Felipe Damiani, Guillermo Bugedo and 2 more

Registry-linked trialAbstract readObservational Study
In one paragraph

Observational study in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03513809 (Spontaneous Breathing and Progression of Lung Injury in Acute Respiratory Distress Syndrome Before Connection to Mechanical Ventilation), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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.

NCT03513809 unknown statusnot on this map

Spontaneous Breathing and Progression of Lung Injury in Acute Respiratory Distress Syndrome Before Connection to Mechanical Ventilation

Typeobservational_patient_registrySponsorPontificia Universidad Catolica de ChileRan2017 to 2021Enrolled40ConditionsAcute Hypoxemic Respiratory Failure, Acute Respiratory Distress SyndromeArmsThoracic electrical impedance tomography
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
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

12 authors.

M Consuelo BachmannDepartamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Martín BenitesDepartamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Vanessa OviedoDepartamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Niki Hamidi VadeghaniEscuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile.
Dagoberto SotoDepartamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Roque BasoaltoDepartamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Pablo CrucesLaboratory of Translational Research in Critical Care, Center for Research on Pandemic Resilience, Faculty of Life Sciences, Universidad Andres Bello, Santiago, Chile.
Yorschua JalilEscuela de Ciencias de la Salud, Departamento de Kinesiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
L Felipe DamianiEscuela de Ciencias de la Salud, Departamento de Kinesiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Guillermo BugedoDepartamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Alejandro BruhnDepartamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Jaime RetamalDepartamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. jaimeretamal@gmail.com.

Funding

Fondo Nacional de Desarrollo Científico y Tecnológico 1171810
6 · The paper itself

Abstract

backgroundIn patients with acute hypoxemic respiratory failure, spontaneous breathing efforts may contribute to patient self-inflicted lung injury through increased ventilation inhomogeneity and systemic inflammation. Whether early transition to controlled mechanical ventilation (CMV) mitigates these effects remains uncertain.

methodsThis observational, prospective cohort study included 40 ICU patients with acute hypoxemic respiratory failure who initially breathed spontaneously. Based on clinical decisions, patients were managed with either continued spontaneous breathing (SB group, n = 12) or transitioned to CMV (CMV group, n = 28). Arterial blood gases, hemodynamics, plasma cytokines (IL-6 and IL-8), and ventilation distribution via electrical impedance tomography (EIT) were recorded at baseline and after 24 h. In the CMV group, intermediate time points (T2, T6, T12) were also assessed after intubation. The trial was registered in ClinicalTrials.gov (NCT03513809).

resultsIn the CMV group, respiratory rate and heart rate decreased significantly over time. IL-6 levels dropped markedly from 305 ± 938 pg/mL at baseline to 27 ± 58 pg/mL at 24 h (p = 0.0195), accompanied by a significant improvement in oxygenation (PaO₂/FiO₂ from 140 ± 51 to 199 ± 67, p = 0.0004). EIT data showed improved ventilation distribution with increased end-expiratory lung impedance, decreased global inhomogeneity, and a shift in the center of ventilation toward dorsal regions. In contrast, the SB group showed no significant changes over 24 h in gas exchange, systemic inflammation, or EIT-derived parameters.

conclusionsIn patients with acute hypoxemic respiratory failure initially breathing spontaneously, transition to CMV was associated with reduced IL-6 levels and improved ventilatory homogeneity over 24 h. These exploratory findings indicate that connection to controlled mechanical ventilation was associated with reduced systemic inflammation, a relationship that warrants confirmation in larger prospective studies.

Indexed as

HypoxiaInflammationRespiration, ArtificialRespiratory InsufficiencyAgedBlood Gas AnalysisCohort StudiesFemaleHumansIntensive Care UnitsInterleukin-6MaleMiddle AgedProspective StudiesInterleukin-6Acute hypoxemic respiratory failureCytokinesElectrical impedance tomographyMechanical ventilationPatient self-inflicted lung injurySpontaneous breathing

Identifiers

PMID41219816
PMCPMC12606846

What OpenQuestion holds

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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.