ArticleAnnals of intensive care2025
Physiological comparison of noninvasive ventilation and CPAP on inspiratory efforts after extubation in critically ill patients with morbid obesity: a post-hoc analysis.
Article in Annals of intensive care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Prophylactic NIV after extubation in non-hypercapnic high-risk patients: moving beyond convenience toward clinical benefit.Intensive care medicine · 2026Article
- Mechanical ventilation for ICU patient with obesity: current best practices and future directions.Intensive care medicine · 2026Review
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNo study has evaluated the inspiratory effort in patients with obesity immediately after extubation according to the noninvasive ventilatory support used. We aimed to determine, in critically ill patients with morbid obesity, whether Non Invasive Ventilation applied with facial mask with Pressure Support above Positive End-Expiratory Pressure (PSV-PEEP) may reduce patient inspiratory efforts to a greater extent than Continuous Positive Airway Pressure (CPAP) after extubation.
methodsWe conducted a post-hoc analysis based on data from a physiological study involving consecutive patients with morbid obesity prior to extubation. Flow, airway, esophageal, and gastric pressure signals were then recorded 20 min after extubation under three distinct conditions: (1) standard oxygen, (2) CPAP and (3) PSV-PEEP. Inspiratory efforts were assessed by calculation of the trans-diaphragmatic pressure (Pdi) and work-of-breathing (WOB).
resultsFifteen patients with mean body mass index of 45 kg/m
conclusionIn critically ill post extubation patients with morbid obesity, both PSV-PEEP and CPAP reduced the inspiratory effort indexes including inspiratory work-of-breathing, traducing an unload of inspiratory muscles. This effect was more important when PSV-PEEP was used in comparison to CPAP, suggesting a more pronounced effect of inspiratory muscle unloading.
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