Download PDF
Semin Respir Crit Care Med 2022; 43(03): 346-368
DOI: 10.1055/s-0042-1748917
Review Article

Monitoring Lung Injury Severity and Ventilation Intensity during Mechanical Ventilation

Emanuele Rezoagli
1   School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
2   Department of Emergency and Intensive Care, San Gerardo University Hospital, Monza, Italy
,
John G. Laffey   *
3   School of Medicine, National University of Ireland, Galway, Ireland
4   Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, Saolta University Hospital Group, Galway, Ireland
5   Lung Biology Group, Regenerative Medicine Institute (REMEDI) at CÚRAM Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland
,
Giacomo Bellani   *
1   School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
2   Department of Emergency and Intensive Care, San Gerardo University Hospital, Monza, Italy
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Acute respiratory distress syndrome (ARDS) is a severe form of respiratory failure burden by high hospital mortality. No specific pharmacologic treatment is currently available and its ventilatory management is a key strategy to allow reparative and regenerative lung tissue processes. Unfortunately, a poor management of mechanical ventilation can induce ventilation induced lung injury (VILI) caused by physical and biological forces which are at play. Different parameters have been described over the years to assess lung injury severity and facilitate optimization of mechanical ventilation. Indices of lung injury severity include variables related to gas exchange abnormalities, ventilatory setting and respiratory mechanics, ventilation intensity, and the presence of lung hyperinflation versus derecruitment. Recently, specific indexes have been proposed to quantify the stress and the strain released over time using more comprehensive algorithms of calculation such as the mechanical power, and the interaction between driving pressure (DP) and respiratory rate (RR) in the novel DP multiplied by four plus RR [(4 × DP) + RR] index. These new parameters introduce the concept of ventilation intensity as contributing factor of VILI. Ventilation intensity should be taken into account to optimize protective mechanical ventilation strategies, with the aim to reduce intensity to the lowest level required to maintain gas exchange to reduce the potential for VILI. This is further gaining relevance in the current era of phenotyping and enrichment strategies in ARDS.

Keywords

lung injury - mechanical ventilation - gas exchange - respiratory mechanics - ventilation intensity

* John G. Laffey and Giacomo Bellani are co–senior authors.




Publication History

Article published online:
27 July 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Levitt JE, Matthay MA. Treatment of acute lung injury: historical perspective and potential future therapies. Semin Respir Crit Care Med 2006; 27 (04) 426-437
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 McNicholas B, Rezoagli E, Laffey JG. Acute hypoxemic respiratory failure and acute respiratory distress syndrome. In: Bellani G. ed. Mechanical Ventilation from Pathophysiology to Clinical Evidence. Springer Nature; 2022
    Search in Google Scholar
  • 3 Ranieri VM, Rubenfeld GD, Thompson BT. et al. ARDS Definition Task Force. Acute respiratory distress syndrome: the Berlin definition. JAMA 2012; 307 (23) 2526-2533
    Search in Google Scholar
  • 4 Pham T, Pesenti A, Bellani G. et al. LUNG SAFE Investigators and the European Society of Intensive Care Medicine Trials Group. Outcome of acute hypoxaemic respiratory failure: insights from the LUNG SAFE Study. Eur Respir J 2021; 57 (06) 2003317
    CrossrefPubMedSearch in Google Scholar
  • 5 Grasselli G, Cattaneo E, Florio G. et al. Mechanical ventilation parameters in critically ill COVID-19 patients: a scoping review. Crit Care 2021; 25 (01) 115
    CrossrefPubMedSearch in Google Scholar
  • 6 Rezoagli E, Magliocca A, Bellani G, Pesenti A, Grasselli G. Development of a critical care response - experiences from Italy during the coronavirus disease 2019 pandemic. Anesthesiol Clin 2021; 39 (02) 265-284
    CrossrefPubMedSearch in Google Scholar
  • 7 Wendel Garcia PD, Aguirre-Bermeo H, Buehler PK. et al. RISC-19-ICU Investigators. Implications of early respiratory support strategies on disease progression in critical COVID-19: a matched subanalysis of the prospective RISC-19-ICU cohort. Crit Care 2021; 25 (01) 175
    CrossrefPubMedSearch in Google Scholar
  • 8 Rezoagli E, Fumagalli R, Bellani G. Definition and epidemiology of acute respiratory distress syndrome. Ann Transl Med 2017; 5 (14) 282
    CrossrefPubMedSearch in Google Scholar
  • 9 Bellani G, Laffey JG, Pham T. et al. LUNG SAFE Investigators, ESICM Trials Group. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA 2016; 315 (08) 788-800
    Search in Google Scholar
  • 10 Horie S, McNicholas B, Rezoagli E. et al. Emerging pharmacological therapies for ARDS: COVID-19 and beyond. Intensive Care Med 2020; 46 (12) 2265-2283
    CrossrefPubMedSearch in Google Scholar
  • 11 Shah FA, Meyer NJ, Angus DC. et al. A research agenda for precision medicine in sepsis and acute respiratory distress syndrome: an official American Thoracic Society Research Statement. Am J Respir Crit Care Med 2021; 204 (08) 891-901
    CrossrefPubMedSearch in Google Scholar
  • 12 Beitler JR, Thompson BT, Baron RM. et al. Advancing precision medicine for acute respiratory distress syndrome. Lancet Respir Med 2022; 10 (01) 107-120
    CrossrefPubMedSearch in Google Scholar
  • 13 Menk M, Estenssoro E, Sahetya SK. et al. Current and evolving standards of care for patients with ARDS. Intensive Care Med 2020; 46 (12) 2157-2167
    CrossrefPubMedSearch in Google Scholar
  • 14 Cardinal-Fernández P, Lorente JA, Ballén-Barragán A, Matute-Bello G. Acute respiratory distress syndrome and diffuse alveolar damage. New insights on a complex relationship. Ann Am Thorac Soc 2017; 14 (06) 844-850
    CrossrefPubMedSearch in Google Scholar
  • 15 Tomashefski Jr JF. Pulmonary pathology of acute respiratory distress syndrome. Clin Chest Med 2000; 21 (03) 435-466
    CrossrefPubMedSearch in Google Scholar
  • 16 Katzenstein AL, Bloor CM, Leibow AA. Diffuse alveolar damage – the role of oxygen, shock, and related factors. A review. Am J Pathol 1976; 85 (01) 209-228
    PubMedSearch in Google Scholar
  • 17 Thille AW, Esteban A, Fernández-Segoviano P. et al. Comparison of the Berlin definition for acute respiratory distress syndrome with autopsy. Am J Respir Crit Care Med 2013; 187 (07) 761-767
    CrossrefPubMedSearch in Google Scholar
  • 18 de Hemptinne Q, Remmelink M, Brimioulle S, Salmon I, Vincent JL. ARDS: a clinicopathological confrontation. Chest 2009; 135 (04) 944-949
    CrossrefPubMedSearch in Google Scholar
  • 19 Thompson BT, Matthay MA. The Berlin definition of ARDS versus pathological evidence of diffuse alveolar damage. Am J Respir Crit Care Med 2013; 187 (07) 675-677
    CrossrefPubMedSearch in Google Scholar
  • 20 Esteban A, Fernández-Segoviano P, Frutos-Vivar F. et al. Comparison of clinical criteria for the acute respiratory distress syndrome with autopsy findings. Ann Intern Med 2004; 141 (06) 440-445
    CrossrefPubMedSearch in Google Scholar
  • 21 Cardinal-Fernández P, Bajwa EK, Dominguez-Calvo A, Menéndez JM, Papazian L, Thompson BT. The presence of diffuse alveolar damage on open lung biopsy is associated with mortality in patients with acute respiratory distress syndrome: a systematic review and meta-analysis. Chest 2016; 149 (05) 1155-1164
    CrossrefPubMedSearch in Google Scholar
  • 22 Santos C, Ferrer M, Roca J, Torres A, Hernández C, Rodriguez-Roisin R. Pulmonary gas exchange response to oxygen breathing in acute lung injury. Am J Respir Crit Care Med 2000; 161 (01) 26-31
    CrossrefPubMedSearch in Google Scholar
  • 23 Coudroy R, Chen L, Pham T, Piraino T, Telias I, Brochard L. Acute respiratory distress syndrome: respiratory monitoring and pulmonary physiology. Semin Respir Crit Care Med 2019; 40 (01) 66-80
    Thieme ConnectPubMedSearch in Google Scholar
  • 24 Nieman GF, Gatto LA, Habashi NM. Impact of mechanical ventilation on the pathophysiology of progressive acute lung injury. J Appl Physiol (1985) 2015; 119 (11) 1245-1261
    CrossrefPubMedSearch in Google Scholar
  • 25 Henzler D, Pelosi P, Bensberg R. et al. Effects of partial ventilatory support modalities on respiratory function in severe hypoxemic lung injury. Crit Care Med 2006; 34 (06) 1738-1745
    CrossrefPubMedSearch in Google Scholar
  • 26 Kallet RH. Patient-ventilator interaction during acute lung injury, and the role of spontaneous breathing: part 1: respiratory muscle function during critical illness. Respir Care 2011; 56 (02) 181-189
    CrossrefPubMedSearch in Google Scholar
  • 27 Mascheroni D, Kolobow T, Fumagalli R, Moretti MP, Chen V, Buckhold D. Acute respiratory failure following pharmacologically induced hyperventilation: an experimental animal study. Intensive Care Med 1988; 15 (01) 8-14
    CrossrefPubMedSearch in Google Scholar
  • 28 Bellani G, Laffey JG, Pham T. et al. LUNG SAFE Investigators, ESICM Trials Group. Noninvasive ventilation of patients with acute respiratory distress syndrome. Insights from the LUNG SAFE Study. Am J Respir Crit Care Med 2017; 195 (01) 67-77
    Search in Google Scholar
  • 29 Brochard L, Slutsky A, Pesenti A. Mechanical ventilation to minimize progression of lung injury in acute respiratory failure. Am J Respir Crit Care Med 2017; 195 (04) 438-442
    Search in Google Scholar
  • 30 Lee WL, Slutsky AS. Ventilator-induced lung injury and recommendations for mechanical ventilation of patients with ARDS. Semin Respir Crit Care Med 2001; 22 (03) 269-280
    Thieme ConnectPubMedSearch in Google Scholar
  • 31 Dreyfuss D, Hubmayr R. What the concept of VILI has taught us about ARDS management. Intensive Care Med 2016; 42 (05) 811-813
    CrossrefPubMedSearch in Google Scholar
  • 32 Slutsky AS, Ranieri VM. Ventilator-induced lung injury. N Engl J Med 2013; 369 (22) 2126-2136
    CrossrefPubMedSearch in Google Scholar
  • 33 Webb HH, Tierney DF. Experimental pulmonary edema due to intermittent positive pressure ventilation with high inflation pressures. Protection by positive end-expiratory pressure. Am Rev Respir Dis 1974; 110 (05) 556-565
    PubMedSearch in Google Scholar
  • 34 Tremblay LN, Slutsky AS. Ventilator-induced injury: from barotrauma to biotrauma. Proc Assoc Am Physicians 1998; 110 (06) 482-488
    PubMedSearch in Google Scholar
  • 35 Mead J, Takishima T, Leith D. Stress distribution in lungs: a model of pulmonary elasticity. J Appl Physiol 1970; 28 (05) 596-608
    CrossrefPubMedSearch in Google Scholar
  • 36 Slutsky AS, Tremblay LN. Multiple system organ failure. Is mechanical ventilation a contributing factor?. Am J Respir Crit Care Med 1998; 157 (6, Pt 1): 1721-1725
    CrossrefPubMedSearch in Google Scholar
  • 37 Ranieri VM, Suter PM, Tortorella C. et al. Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: a randomized controlled trial. JAMA 1999; 282 (01) 54-61
    CrossrefPubMedSearch in Google Scholar
  • 38 Wakabayashi K, Wilson MR, Tatham KC, O'Dea KP, Takata M. Volutrauma, but not atelectrauma, induces systemic cytokine production by lung-marginated monocytes. Crit Care Med 2014; 42 (01) e49-e57
    CrossrefPubMedSearch in Google Scholar
  • 39 Gajic O, Dara SI, Mendez JL. et al. Ventilator-associated lung injury in patients without acute lung injury at the onset of mechanical ventilation. Crit Care Med 2004; 32 (09) 1817-1824
    CrossrefPubMedSearch in Google Scholar
  • 40 Gajic O, Frutos-Vivar F, Esteban A, Hubmayr RD, Anzueto A. Ventilator settings as a risk factor for acute respiratory distress syndrome in mechanically ventilated patients. Intensive Care Med 2005; 31 (07) 922-926
    CrossrefPubMedSearch in Google Scholar
  • 41 Tsuno K, Prato P, Kolobow T. Acute lung injury from mechanical ventilation at moderately high airway pressures. J Appl Physiol (1985) 1990; 69 (03) 956-961
    CrossrefPubMedSearch in Google Scholar
  • 42 Kolobow T, Moretti MP, Fumagalli R. et al. Severe impairment in lung function induced by high peak airway pressure during mechanical ventilation. An experimental study. Am Rev Respir Dis 1987; 135 (02) 312-315
    PubMedSearch in Google Scholar
  • 43 Kolobow T. Acute respiratory failure. On how to injure healthy lungs (and prevent sick lungs from recovering). ASAIO Trans 1988; 34 (01) 31-34
    PubMedSearch in Google Scholar
  • 44 Lumb AB. ed. Diffusion of respiratory gases. In: Nunn's Applied Respiratory Physiology. 7th ed. Churchill Livingstone; 2010
    Search in Google Scholar
  • 45 Radermacher P, Maggiore SM, Mercat A. Fifty years of research in ARDS. Gas exchange in acute respiratory distress syndrome. Am J Respir Crit Care Med 2017; 196 (08) 964-984
    CrossrefPubMedSearch in Google Scholar
  • 46 Wagner PD, Laravuso RB, Goldzimmer E, Naumann PF, West JB. Distribution of ventilation-perfusion ratios in dogs with normal and abnormal lungs. J Appl Physiol 1975; 38 (06) 1099-1109
    CrossrefPubMedSearch in Google Scholar
  • 47 Fenn WO, Rahn H, Otis AB. A theoretical study of the composition of the alveolar air at altitude. Am J Physiol 1946; 146: 637-653
    CrossrefPubMedSearch in Google Scholar
  • 48 Wagner PD, Laravuso RB, Uhl RR, West JB. Continuous distributions of ventilation-perfusion ratios in normal subjects breathing air and 100 per cent O2. J Clin Invest 1974; 54 (01) 54-68
    CrossrefPubMedSearch in Google Scholar
  • 49 Riley RL, Cournand A. Ideal alveolar air and the analysis of ventilation-perfusion relationships in the lungs. J Appl Physiol 1949; 1 (12) 825-847
    CrossrefPubMedSearch in Google Scholar
  • 50 West JB. State of the art: ventilation-perfusion relationships. Am Rev Respir Dis 1977; 116 (05) 919-943
    PubMedSearch in Google Scholar
  • 51 West JB. Understanding pulmonary gas exchange: ventilation-perfusion relationships. Am J Physiol Lung Cell Mol Physiol 2004; 287 (06) L1071-L1072
    CrossrefPubMedSearch in Google Scholar
  • 52 Dantzker DR, Brook CJ, Dehart P, Lynch JP, Weg JG. Ventilation-perfusion distributions in the adult respiratory distress syndrome. Am Rev Respir Dis 1979; 120 (05) 1039-1052
    PubMedSearch in Google Scholar
  • 53 West JB, Luks AM. eds. Gas transport by the blood: how gases are moved to and from the peripheral tissues. In: West's Respiratory Physiology: The Essentials. 11th ed. Wolters Kluwer Health; 2016
    Search in Google Scholar
  • 54 Wagner PD, Saltzman HA, West JB. Measurement of continuous distributions of ventilation-perfusion ratios: theory. J Appl Physiol 1974; 36 (05) 588-599
    CrossrefPubMedSearch in Google Scholar
  • 55 Petersson J, Glenny RW. Gas exchange and ventilation-perfusion relationships in the lung. Eur Respir J 2014; 44 (04) 1023-1041
    CrossrefPubMedSearch in Google Scholar
  • 56 Dantzker DR, Wagner PD, West JB. Instability of lung units with low Va/Q ratios during O2 breathing. J Appl Physiol 1975; 38 (05) 886-895
    CrossrefPubMedSearch in Google Scholar
  • 57 Said SI, Banerjee CM. Venous admixture to the pulmonary circulation in human subjects breathing 100 per cent oxygen. J Clin Invest 1963; 42 (04) 507-515
    CrossrefPubMedSearch in Google Scholar
  • 58 Farhi LE, Rahn H. A theoretical analysis of the alveolar-arterial O2 difference with special reference to the distribution effect. J Appl Physiol 1955; 7 (06) 699-703
    CrossrefPubMedSearch in Google Scholar
  • 59 West JB, Wagner PD. Pulmonary gas exchange. In: West JB, ed. Bioengineering Aspects of the Lung: Dekker, New York; 1977: 361-457
    Search in Google Scholar
  • 60 Douglas ME, Downs JB, Dannemiller FJ, Hodges MR, Munson ES. Change in pulmonary venous admixture with varying inspired oxygen. Anesth Analg 1976; 55 (05) 688-695
    CrossrefPubMedSearch in Google Scholar
  • 61 Moudgil R, Michelakis ED, Archer SL. Hypoxic pulmonary vasoconstriction. J Appl Physiol (1985) 2005; 98 (01) 390-403
    CrossrefPubMedSearch in Google Scholar
  • 62 Newman JH, Loyd JE, English DK, Ogletree ML, Fulkerson WJ, Brigham KL. Effects of 100% oxygen on lung vascular function in awake sheep. J Appl Physiol 1983; 54 (05) 1379-1386
    CrossrefPubMedSearch in Google Scholar
  • 63 Benatar SR, Hewlett AM, Nunn JF. The use of iso-shunt lines for control of oxygen therapy. Br J Anaesth 1973; 45 (07) 711-718
    CrossrefPubMedSearch in Google Scholar
  • 64 Lumb AB, Slinger P. Hypoxic pulmonary vasoconstriction: physiology and anesthetic implications. Anesthesiology 2015; 122 (04) 932-946
    CrossrefPubMedSearch in Google Scholar
  • 65 Sylvester JT, Shimoda LA, Aaronson PI, Ward JPT. Hypoxic pulmonary vasoconstriction. Physiol Rev 2012; 92 (01) 367-520
    CrossrefPubMedSearch in Google Scholar
  • 66 Rothen HU, Sporre B, Engberg G, Wegenius G, Reber A, Hedenstierna G. Prevention of atelectasis during general anaesthesia. Lancet 1995; 345 (8962): 1387-1391
    CrossrefPubMedSearch in Google Scholar
  • 67 Suter PM, Fairley HB, Schlobohm RM. Shunt, lung volume and perfusion during short periods of ventilation with oxygen. Anesthesiology 1975; 43 (06) 617-627
    CrossrefPubMedSearch in Google Scholar
  • 68 McAslan TC, Matjasko-Chiu J, Turney SZ, Cowley RA. Influence of inhalation of 100 percent oxygen on intrapulmonary shunt in severely traumatized patients. J Trauma 1973; 13 (09) 811-821
    CrossrefPubMedSearch in Google Scholar
  • 69 Karbing DS, Kjærgaard S, Andreassen S, Espersen K, Rees SE. Minimal model quantification of pulmonary gas exchange in intensive care patients. Med Eng Phys 2011; 33 (02) 240-248
    CrossrefPubMedSearch in Google Scholar
  • 70 Karbing DS, Panigada M, Bottino N. et al. Changes in shunt, ventilation/perfusion mismatch, and lung aeration with PEEP in patients with ARDS: a prospective single-arm interventional study. Crit Care 2020; 24 (01) 111
    CrossrefPubMedSearch in Google Scholar
  • 71 Gattinoni L, Caironi P, Cressoni M. et al. Lung recruitment in patients with the acute respiratory distress syndrome. N Engl J Med 2006; 354 (17) 1775-1786
    CrossrefPubMedSearch in Google Scholar
  • 72 Aboab J, Louis B, Jonson B, Brochard L. Relation between PaO2/FIO2 ratio and FIO2: a mathematical description. Intensive Care Med 2006; 32 (10) 1494-1497
    CrossrefPubMedSearch in Google Scholar
  • 73 Karbing DS, Kjaergaard S, Smith BW. et al. Variation in the PaO2/FiO2 ratio with FiO2: mathematical and experimental description, and clinical relevance. Crit Care 2007; 11 (06) R118
    CrossrefPubMedSearch in Google Scholar
  • 74 Gowda MS, Klocke RA. Variability of indices of hypoxemia in adult respiratory distress syndrome. Crit Care Med 1997; 25 (01) 41-45
    CrossrefPubMedSearch in Google Scholar
  • 75 Gilbert R, Auchincloss Jr JH, Kuppinger M, Thomas MV. Stability of the arterial/alveolar oxygen partial pressure ratio. Effects of low ventilation/perfusion regions. Crit Care Med 1979; 7 (06) 267-272
    CrossrefPubMedSearch in Google Scholar
  • 76 Maiolo G, Collino F, Vasques F. et al. Reclassifying acute respiratory distress syndrome. Am J Respir Crit Care Med 2018; 197 (12) 1586-1595
    CrossrefPubMedSearch in Google Scholar
  • 77 Urner M, Jüni P, Hansen B, Wettstein MS, Ferguson ND, Fan E. Time-varying intensity of mechanical ventilation and mortality in patients with acute respiratory failure: a registry-based, prospective cohort study. Lancet Respir Med 2020; 8 (09) 905-913
    CrossrefPubMedSearch in Google Scholar
  • 78 Ruan SY, Huang CT, Chang HT. et al. Construct validity of PaO2/FiO2 ratios in defining acute respiratory distress syndrome. Am J Respir Crit Care Med 2022; 205 (03) 364-366
    CrossrefPubMedSearch in Google Scholar
  • 79 Schumacher RE, Roloff DW, Chapman R, Snedecor S, Bartlett RH. Extracorporeal membrane oxygenation in term newborns. A prospective cost-benefit analysis. ASAIO J 1993; 39 (04) 873-879
    CrossrefPubMedSearch in Google Scholar
  • 80 Ortiz RM, Cilley RE, Bartlett RH. Extracorporeal membrane oxygenation in pediatric respiratory failure. Pediatr Clin North Am 1987; 34 (01) 39-46
    CrossrefPubMedSearch in Google Scholar
  • 81 Trachsel D, McCrindle BW, Nakagawa S, Bohn D. Oxygenation index predicts outcome in children with acute hypoxemic respiratory failure. Am J Respir Crit Care Med 2005; 172 (02) 206-211
    CrossrefPubMedSearch in Google Scholar
  • 82 Dechert RE, Park PK, Bartlett RH. Evaluation of the oxygenation index in adult respiratory failure. J Trauma Acute Care Surg 2014; 76 (02) 469-473
    CrossrefPubMedSearch in Google Scholar
  • 83 Palanidurai S, Phua J, Chan YH, Mukhopadhyay A. P/FP ratio: incorporation of PEEP into the PaO2/FiO2 ratio for prognostication and classification of acute respiratory distress syndrome. Ann Intensive Care 2021; 11 (01) 124
    CrossrefPubMedSearch in Google Scholar
  • 84 Schaefer MS, Loring SH, Talmor D, Baedorf-Kassis EN. Comparison of mechanical power estimations in mechanically ventilated patients with ARDS: a secondary data analysis from the EPVent study. Intensive Care Med 2021; 47 (01) 130-132
    CrossrefPubMedSearch in Google Scholar
  • 85 Caironi P, Carlesso E, Cressoni M. et al. Lung recruitability is better estimated according to the Berlin definition of acute respiratory distress syndrome at standard 5 cm H2O rather than higher positive end-expiratory pressure: a retrospective cohort study. Crit Care Med 2015; 43 (04) 781-790
    CrossrefPubMedSearch in Google Scholar
  • 86 Riviello ED, Kiviri W, Twagirumugabe T. et al. Hospital incidence and outcomes of the acute respiratory distress syndrome using the Kigali Modification of the Berlin definition. Am J Respir Crit Care Med 2016; 193 (01) 52-59
    CrossrefPubMedSearch in Google Scholar
  • 87 Nuckton TJ, Alonso JA, Kallet RH. et al. Pulmonary dead-space fraction as a risk factor for death in the acute respiratory distress syndrome. N Engl J Med 2002; 346 (17) 1281-1286
    CrossrefPubMedSearch in Google Scholar
  • 88 Lucangelo U, Bernabè F, Vatua S. et al. Prognostic value of different dead space indices in mechanically ventilated patients with acute lung injury and ARDS. Chest 2008; 133 (01) 62-71
    CrossrefPubMedSearch in Google Scholar
  • 89 Kallet RH, Zhuo H, Liu KD, Calfee CS, Matthay MA. National Heart Lung and Blood Institute ARDS Network Investigators. The association between physiologic dead-space fraction and mortality in subjects with ARDS enrolled in a prospective multi-center clinical trial. Respir Care 2014; 59 (11) 1611-1618
    CrossrefPubMedSearch in Google Scholar
  • 90 Workman JM, Penman RW, Bromberger-Barnea B, Permutt S, Riley RL. Alveolar dead space, alveolar shunt, and transpulmonary pressure. J Appl Physiol 1965; 20 (05) 816-824
    CrossrefPubMedSearch in Google Scholar
  • 91 Robertson HT. Dead space: the physiology of wasted ventilation. Eur Respir J 2015; 45 (06) 1704-1716
    CrossrefPubMedSearch in Google Scholar
  • 92 Sinha P, Flower O, Soni N. Dead space ventilation: a waste of breath!. Intensive Care Med 2011; 37 (05) 735-746
    CrossrefPubMedSearch in Google Scholar
  • 93 Bohr C. Uber die Lungenathmung. Skand Arch Physiol 1891; 2: 236
    CrossrefPubMedSearch in Google Scholar
  • 94 Enghoff H. Volumen inefficax. Bermekungen zur Frage des shadlichen. Raumes Upsala Lakareforen Forh 1938; 44: 191-218
    PubMedSearch in Google Scholar
  • 95 Morales-Quinteros L, Schultz MJ, Bringué J. et al. MARS Consortium. Estimated dead space fraction and the ventilatory ratio are associated with mortality in early ARDS. Ann Intensive Care 2019; 9 (01) 128
    CrossrefPubMedSearch in Google Scholar
  • 96 Doorduin J, Nollet JL, Vugts MPAJ. et al. Assessment of dead-space ventilation in patients with acute respiratory distress syndrome: a prospective observational study. Crit Care 2016; 20 (01) 121
    CrossrefPubMedSearch in Google Scholar
  • 97 Siddiki H, Kojicic M, Li G. et al. Bedside quantification of dead-space fraction using routine clinical data in patients with acute lung injury: secondary analysis of two prospective trials. Crit Care 2010; 14 (04) R141
    CrossrefPubMedSearch in Google Scholar
  • 98 Blanch L, Lucangelo U, Lopez-Aguilar J, Fernandez R, Romero PV. Volumetric capnography in patients with acute lung injury: effects of positive end-expiratory pressure. Eur Respir J 1999; 13 (05) 1048-1054
    CrossrefPubMedSearch in Google Scholar
  • 99 Shimada Y, Yoshiya I, Tanaka K, Sone S, Sakurai M. Evaluation of the progress and prognosis of adult respiratory distress syndrome. Simple respiratory physiologic measurement. Chest 1979; 76 (02) 180-186
    CrossrefPubMedSearch in Google Scholar
  • 100 Fenn WO, Rahn H. Handbook of Physiology. Washington, DC: American Physiological Society; 1964
    Search in Google Scholar
  • 101 Wexler HR, Lok P. A simple formula for adjusting arterial carbon dioxide tension. Can Anaesth Soc J 1981; 28 (04) 370-372
    CrossrefPubMedSearch in Google Scholar
  • 102 Sinha P, Fauvel NJ, Singh S, Soni N. Ventilatory ratio: a simple bedside measure of ventilation. Br J Anaesth 2009; 102 (05) 692-697
    CrossrefPubMedSearch in Google Scholar
  • 103 Sinha P, Sanders RD, Soni N, Vukoja MK, Gajic O. Acute respiratory distress syndrome: the prognostic value of ventilatory ratio – a simple bedside tool to monitor ventilatory efficiency. Am J Respir Crit Care Med 2013; 187 (10) 1150-1153
    CrossrefPubMedSearch in Google Scholar
  • 104 Sinha P, Calfee CS, Beitler JR. et al. Physiologic analysis and clinical performance of the ventilatory ratio in acute respiratory distress syndrome. Am J Respir Crit Care Med 2019; 199 (03) 333-341
    CrossrefPubMedSearch in Google Scholar
  • 105 Grieco DL, Bongiovanni F, Chen L. et al. Respiratory physiology of COVID-19-induced respiratory failure compared to ARDS of other etiologies. Crit Care 2020; 24 (01) 529
    CrossrefPubMedSearch in Google Scholar
  • 106 Sjoding MW, Admon AJ, Saha AK. et al. Comparing clinical features and outcomes in mechanically ventilated patients with COVID-19 and acute respiratory distress syndrome. Ann Am Thorac Soc 2021; 18 (11) 1876-1885
    CrossrefPubMedSearch in Google Scholar
  • 107 Beloncle F, Studer A, Seegers V. et al. Longitudinal changes in compliance, oxygenation and ventilatory ratio in COVID-19 versus non-COVID-19 pulmonary acute respiratory distress syndrome. Crit Care 2021; 25 (01) 248
    CrossrefPubMedSearch in Google Scholar
  • 108 Torres A, Motos A, Riera J. et al. CIBERESUCICOVID Project (COV20/00110, ISCIII). The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients. Crit Care 2021; 25 (01) 331
    CrossrefPubMedSearch in Google Scholar
  • 109 Brower RG, Matthay MA, Morris A, Schoenfeld D, Thompson BT, Wheeler A. Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 2000; 342 (18) 1301-1308
    Search in Google Scholar
  • 110 Fan E, Del Sorbo L, Goligher EC. et al. American Thoracic Society, European Society of Intensive Care Medicine, and Society of Critical Care Medicine. An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical ventilation in adult patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 2017; 195 (09) 1253-1263
    CrossrefPubMedSearch in Google Scholar
  • 111 Eichacker PQ, Gerstenberger EP, Banks SM, Cui X, Natanson C. Meta-analysis of acute lung injury and acute respiratory distress syndrome trials testing low tidal volumes. Am J Respir Crit Care Med 2002; 166 (11) 1510-1514
    CrossrefPubMedSearch in Google Scholar
  • 112 Walkey AJ, Goligher EC, Del Sorbo L. et al. Low tidal volume versus non-volume-limited strategies for patients with acute respiratory distress syndrome. A systematic review and meta-analysis. Ann Am Thorac Soc 2017; 14 (04, Supp 4): S271-S279
    CrossrefPubMedSearch in Google Scholar
  • 113 Goligher EC, Costa ELV, Yarnell CJ. et al. Effect of lowering Vt on mortality in acute respiratory distress syndrome varies with respiratory system elastance. Am J Respir Crit Care Med 2021; 203 (11) 1378-1385
    CrossrefPubMedSearch in Google Scholar
  • 114 Serpa Neto A, Cardoso SO, Manetta JA. et al. Association between use of lung-protective ventilation with lower tidal volumes and clinical outcomes among patients without acute respiratory distress syndrome: a meta-analysis. JAMA 2012; 308 (16) 1651-1659
    CrossrefPubMedSearch in Google Scholar
  • 115 Serpa Neto A, Hemmes SN, Barbas CS. et al. PROVE Network Investigators. Protective versus conventional ventilation for surgery: a systematic review and individual patient data meta-analysis. Anesthesiology 2015; 123 (01) 66-78
    CrossrefPubMedSearch in Google Scholar
  • 116 Serpa Neto A, Simonis FD, Barbas CS. et al. Association between tidal volume size, duration of ventilation, and sedation needs in patients without acute respiratory distress syndrome: an individual patient data meta-analysis. Intensive Care Med 2014; 40 (07) 950-957
    CrossrefPubMedSearch in Google Scholar
  • 117 Mascia L, Zavala E, Bosma K. et al. Brain IT Group. High tidal volume is associated with the development of acute lung injury after severe brain injury: an international observational study. Crit Care Med 2007; 35 (08) 1815-1820
    CrossrefPubMedSearch in Google Scholar
  • 118 Ladha K, Vidal Melo MF, McLean DJ. et al. Intraoperative protective mechanical ventilation and risk of postoperative respiratory complications: hospital based registry study. BMJ 2015; 351 (July): h3646
    CrossrefPubMedSearch in Google Scholar
  • 119 Determann RM, Royakkers A, Wolthuis EK. et al. Ventilation with lower tidal volumes as compared with conventional tidal volumes for patients without acute lung injury: a preventive randomized controlled trial. Crit Care 2010; 14 (01) R1
    CrossrefPubMedSearch in Google Scholar
  • 120 Futier E, Constantin JM, Paugam-Burtz C. et al. IMPROVE Study Group. A trial of intraoperative low-tidal-volume ventilation in abdominal surgery. N Engl J Med 2013; 369 (05) 428-437
    CrossrefPubMedSearch in Google Scholar
  • 121 Ely EW, Shintani A, Truman B. et al. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA 2004; 291 (14) 1753-1762
    CrossrefPubMedSearch in Google Scholar
  • 122 Simonis FD, Serpa Neto A, Binnekade JM. et al. Writing Group for the PReVENT Investigators. Effect of a low vs intermediate tidal volume strategy on ventilator-free days in intensive care unit patients without ARDS: a randomized clinical trial. JAMA 2018; 320 (18) 1872-1880
    CrossrefPubMedSearch in Google Scholar
  • 123 Hotchkiss Jr JR, Blanch L, Murias G. et al. Effects of decreased respiratory frequency on ventilator-induced lung injury. Am J Respir Crit Care Med 2000; 161 (2, Pt 1): 463-468
    CrossrefPubMedSearch in Google Scholar
  • 124 Rich PB, Douillet CD, Hurd H, Boucher RC. Effect of ventilatory rate on airway cytokine levels and lung injury. J Surg Res 2003; 113 (01) 139-145
    CrossrefPubMedSearch in Google Scholar
  • 125 Protti A, Maraffi T, Milesi M. et al. Role of strain rate in the pathogenesis of ventilator-induced lung edema. Crit Care Med 2016; 44 (09) e838-e845
    CrossrefPubMedSearch in Google Scholar
  • 126 Laffey JG, Bellani G, Pham T. et al. LUNG SAFE Investigators and the ESICM Trials Group. Potentially modifiable factors contributing to outcome from acute respiratory distress syndrome: the LUNG SAFE study. Intensive Care Med 2016; 42 (12) 1865-1876
    CrossrefPubMedSearch in Google Scholar
  • 127 Gattinoni L, Tonetti T, Cressoni M. et al. Ventilator-related causes of lung injury: the mechanical power. Intensive Care Med 2016; 42 (10) 1567-1575
    CrossrefPubMedSearch in Google Scholar
  • 128 Costa ELV, Slutsky AS, Brochard LJ. et al. Ventilatory variables and mechanical power in patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 2021; 204 (03) 303-311
    CrossrefPubMedSearch in Google Scholar
  • 129 Bikker IG, van Bommel J, Reis Miranda D, Bakker J, Gommers D. End-expiratory lung volume during mechanical ventilation: a comparison with reference values and the effect of positive end-expiratory pressure in intensive care unit patients with different lung conditions. Crit Care 2008; 12 (06) R145
    CrossrefPubMedSearch in Google Scholar
  • 130 Patroniti N, Saini M, Zanella A. et al. Measurement of end-expiratory lung volume by oxygen washin-washout in controlled and assisted mechanically ventilated patients. Intensive Care Med 2008; 34 (12) 2235-2240
    CrossrefPubMedSearch in Google Scholar
  • 131 Patroniti N, Bellani G, Manfio A. et al. Lung volume in mechanically ventilated patients: measurement by simplified helium dilution compared to quantitative CT scan. Intensive Care Med 2004; 30 (02) 282-289
    CrossrefPubMedSearch in Google Scholar
  • 132 Gattinoni L, Pesenti A, Bombino M. et al. Relationships between lung computed tomographic density, gas exchange, and PEEP in acute respiratory failure. Anesthesiology 1988; 69 (06) 824-832
    CrossrefPubMedSearch in Google Scholar
  • 133 Gattinoni L, D'Andrea L, Pelosi P, Vitale G, Pesenti A, Fumagalli R. Regional effects and mechanism of positive end-expiratory pressure in early adult respiratory distress syndrome. JAMA 1993; 269 (16) 2122-2127
    CrossrefPubMedSearch in Google Scholar
  • 134 Chiumello D, Marino A, Brioni M. et al. Lung recruitment assessed by respiratory mechanics and computed tomography in patients with acute respiratory distress syndrome. What is the relationship?. Am J Respir Crit Care Med 2016; 193 (11) 1254-1263
    CrossrefPubMedSearch in Google Scholar
  • 135 Gattinoni L, Pesenti A, Avalli L, Rossi F, Bombino M. Pressure-volume curve of total respiratory system in acute respiratory failure. Computed tomographic scan study. Am Rev Respir Dis 1987; 136 (03) 730-736
    CrossrefPubMedSearch in Google Scholar
  • 136 Chiumello D, Cressoni M, Chierichetti M. et al. Nitrogen washout/washin, helium dilution and computed tomography in the assessment of end expiratory lung volume. Crit Care 2008; 12 (06) R150
    Search in Google Scholar
  • 137 Olegård C, Söndergaard S, Houltz E, Lundin S, Stenqvist O. Estimation of functional residual capacity at the bedside using standard monitoring equipment: a modified nitrogen washout/washin technique requiring a small change of the inspired oxygen fraction. Anesth Analg 2005; 101 (01) 206-212
    CrossrefPubMedSearch in Google Scholar
  • 138 Rezoagli E, Bellani G. How I set up positive end-expiratory pressure: evidence- and physiology-based!. Crit Care 2019; 23 (01) 412
    CrossrefPubMedSearch in Google Scholar
  • 139 Maggiore SM, Jonson B, Richard JC, Jaber S, Lemaire F, Brochard L. Alveolar derecruitment at decremental positive end-expiratory pressure levels in acute lung injury: comparison with the lower inflection point, oxygenation, and compliance. Am J Respir Crit Care Med 2001; 164 (05) 795-801
    CrossrefPubMedSearch in Google Scholar
  • 140 Patroniti N, Bellani G, Cortinovis B. et al. Role of absolute lung volume to assess alveolar recruitment in acute respiratory distress syndrome patients. Crit Care Med 2010; 38 (05) 1300-1307
    CrossrefPubMedSearch in Google Scholar
  • 141 Dellamonica J, Lerolle N, Sargentini C. et al. PEEP-induced changes in lung volume in acute respiratory distress syndrome. Two methods to estimate alveolar recruitment. Intensive Care Med 2011; 37 (10) 1595-1604
    CrossrefPubMedSearch in Google Scholar
  • 142 Chen L, Del Sorbo L, Grieco DL. et al. Potential for lung recruitment estimated by the recruitment-to-inflation ratio in acute respiratory distress syndrome. A clinical trial. Am J Respir Crit Care Med 2020; 201 (02) 178-187
    Search in Google Scholar
  • 143 Gattinoni L, Caironi P, Pelosi P, Goodman LR. What has computed tomography taught us about the acute respiratory distress syndrome?. Am J Respir Crit Care Med 2001; 164 (09) 1701-1711
    CrossrefPubMedSearch in Google Scholar
  • 144 Gattinoni L, Pesenti A. ARDS: the non-homogeneous lung; facts and hypothesis. Intensive Crit Care Dig 1987; 6: 1-44
    PubMedSearch in Google Scholar
  • 145 Gattinoni L, Pesenti A. The concept of “baby lung”. Intensive Care Med 2005; 31 (06) 776-784
    CrossrefPubMedSearch in Google Scholar
  • 146 Gattinoni L, Pesenti A, Baglioni S, Vitale G, Rivolta M, Pelosi P. Inflammatory pulmonary edema and positive end-expiratory pressure: correlations between imaging and physiologic studies. J Thorac Imaging 1988; 3 (03) 59-64
    CrossrefPubMedSearch in Google Scholar
  • 147 Gattinoni L, Pesenti A, Caspani ML. et al. The role of total static lung compliance in the management of severe ARDS unresponsive to conventional treatment. Intensive Care Med 1984; 10 (03) 121-126
    CrossrefPubMedSearch in Google Scholar
  • 148 Grasselli G, Tonetti T, Protti A. et al. Collaborators. Pathophysiology of COVID-19-associated acute respiratory distress syndrome: a multicentre prospective observational study. Lancet Respir Med 2020; 8 (12) 1201-1208
    CrossrefPubMedSearch in Google Scholar
  • 149 Li Bassi G, Suen JY, Dalton HJ. et al. COVID-19 Critical Care Consortium. An appraisal of respiratory system compliance in mechanically ventilated COVID-19 patients. Crit Care 2021; 25 (01) 199
    CrossrefPubMedSearch in Google Scholar
  • 150 Vandenbunder B, Ehrmann S, Piagnerelli M. et al. COVADIS Study Group. Static compliance of the respiratory system in COVID-19 related ARDS: an international multicenter study. Crit Care 2021; 25 (01) 52
    CrossrefPubMedSearch in Google Scholar
  • 151 Hager DN, Krishnan JA, Hayden DL, Brower RG. ARDS Clinical Trials Network. Tidal volume reduction in patients with acute lung injury when plateau pressures are not high. Am J Respir Crit Care Med 2005; 172 (10) 1241-1245
    CrossrefPubMedSearch in Google Scholar
  • 152 Diehl JL, Talmor D. When could airway plateau pressure above 30 cmH2O be acceptable in ARDS patients?. Intensive Care Med 2021; 47 (09) 1028-1031
    CrossrefPubMedSearch in Google Scholar
  • 153 Amato MBP, Meade MO, Slutsky AS. et al. Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 2015; 372 (08) 747-755
    Search in Google Scholar
  • 154 Chiumello D, Carlesso E, Brioni M, Cressoni M. Airway driving pressure and lung stress in ARDS patients. Crit Care 2016; 20: 276
    CrossrefPubMedSearch in Google Scholar
  • 155 Gattinoni L, Carlesso E, Caironi P. Stress and strain within the lung. Curr Opin Crit Care 2012; 18 (01) 42-47
    CrossrefPubMedSearch in Google Scholar
  • 156 Chiumello D, Carlesso E, Cadringher P. et al. Lung stress and strain during mechanical ventilation for acute respiratory distress syndrome. Am J Respir Crit Care Med 2008; 178 (04) 346-355
    CrossrefPubMedSearch in Google Scholar
  • 157 Ranieri VM, Brienza N, Santostasi S. et al. Impairment of lung and chest wall mechanics in patients with acute respiratory distress syndrome: role of abdominal distension. Am J Respir Crit Care Med 1997; 156 (4, Pt 1): 1082-1091
    CrossrefPubMedSearch in Google Scholar
  • 158 Goligher EC, Costa ELV. Reply to Tobin. Am J Respir Crit Care Med 2021; 204 (07) 869-870
    CrossrefPubMedSearch in Google Scholar
  • 159 Henderson WR, Chen L, Amato MBP, Brochard LJ. Fifty years of research in ARDS. Respiratory mechanics in acute respiratory distress syndrome. Am J Respir Crit Care Med 2017; 196 (07) 822-833
    CrossrefPubMedSearch in Google Scholar
  • 160 Teggia-Droghi M, Grassi A, Rezoagli E. et al. Comparison of two approaches to estimate driving pressure during assisted ventilation. Am J Respir Crit Care Med 2020; 202 (11) 1595-1598
    CrossrefPubMedSearch in Google Scholar
  • 161 Bellani G, Grassi A, Sosio S. et al. Driving pressure is associated with outcome during assisted ventilation in acute respiratory distress syndrome. Anesthesiology 2019; 131 (03) 594-604
    CrossrefPubMedSearch in Google Scholar
  • 162 Eissa NT, Ranieri VM, Corbeil C. et al. Analysis of behavior of the respiratory system in ARDS patients: effects of flow, volume, and time. J Appl Physiol (1985) 1991; 70 (06) 2719-2729
    CrossrefPubMedSearch in Google Scholar
  • 163 Pesenti A, Pelosi P, Rossi N, Virtuani A, Brazzi L, Rossi A. The effects of positive end-expiratory pressure on respiratory resistance in patients with the adult respiratory distress syndrome and in normal anesthetized subjects. Am Rev Respir Dis 1991; 144 (01) 101-107
    CrossrefPubMedSearch in Google Scholar
  • 164 Mauri T, Lazzeri M, Bellani G, Zanella A, Grasselli G. Respiratory mechanics to understand ARDS and guide mechanical ventilation. Physiol Meas 2017; 38 (12) R280-H303
    CrossrefPubMedSearch in Google Scholar
  • 165 Brody AW, Dubois AB. Determination of tissue, airway and total resistance to respiration in cats. J Appl Physiol 1956; 9 (02) 213-218
    CrossrefPubMedSearch in Google Scholar
  • 166 Otis AB, McKerrow CB, Bartlett RA. et al. Mechanical factors in distribution of pulmonary ventilation. J Appl Physiol 1956; 8 (04) 427-443
    CrossrefPubMedSearch in Google Scholar
  • 167 D'Angelo E, Calderini E, Torri G, Robatto FM, Bono D, Milic-Emili J. Respiratory mechanics in anesthetized paralyzed humans: effects of flow, volume, and time. J Appl Physiol (1985) 1989; 67 (06) 2556-2564
    CrossrefPubMedSearch in Google Scholar
  • 168 D'Angelo E, Prandi E, Tavola M, Calderini E, Milic-Emili J. Chest wall interrupter resistance in anesthetized paralyzed humans. J Appl Physiol (1985) 1994; 77 (02) 883-887
    CrossrefPubMedSearch in Google Scholar
  • 169 Santini A, Mauri T, Dalla Corte F, Spinelli E, Pesenti A.. Effects of inspiratory flow on lung stress, pendelluft, and ventilation heterogeneity in ARDS: a physiological study. Crit Care 2019; Nov 21; 23 (01) 369
    CrossrefPubMedSearch in Google Scholar
  • 170 Matthay MA, Folkesson HG, Clerici C. Lung epithelial fluid transport and the resolution of pulmonary edema. Physiol Rev 2002; 82 (03) 569-600
    CrossrefPubMedSearch in Google Scholar
  • 171 Frank JA, Briot R, Lee JW, Ishizaka A, Uchida T, Matthay MA. Physiological and biochemical markers of alveolar epithelial barrier dysfunction in perfused human lungs. Am J Physiol Lung Cell Mol Physiol 2007; 293 (01) L52-L59
    CrossrefPubMedSearch in Google Scholar
  • 172 Sakuma T, Okaniwa G, Nakada T, Nishimura T, Fujimura S, Matthay MA. Alveolar fluid clearance in the resected human lung. Am J Respir Crit Care Med 1994; 150 (02) 305-310
    CrossrefPubMedSearch in Google Scholar
  • 173 Perkins GD, Gao F, Thickett DR. In vivo and in vitro effects of salbutamol on alveolar epithelial repair in acute lung injury. Thorax 2008; 63 (03) 215-220
    CrossrefPubMedSearch in Google Scholar
  • 174 Perkins GD, McAuley DF, Thickett DR, Gao F. The beta-agonist lung injury trial (BALTI): a randomized placebo-controlled clinical trial. Am J Respir Crit Care Med 2006; 173 (03) 281-287
    CrossrefPubMedSearch in Google Scholar
  • 175 Wright PE, Carmichael LC, Bernard GR. Effect of bronchodilators on lung mechanics in the acute respiratory distress syndrome (ARDS). Chest 1994; 106 (05) 1517-1523
    CrossrefPubMedSearch in Google Scholar
  • 176 Junhasavasdikul D, Telias I, Grieco DL. et al. Expiratory flow limitation during mechanical ventilation. Chest 2018; 154 (04) 948-962
    CrossrefPubMedSearch in Google Scholar
  • 177 Koutsoukou A, Armaganidis A, Stavrakaki-Kallergi C. et al. Expiratory flow limitation and intrinsic positive end-expiratory pressure at zero positive end-expiratory pressure in patients with adult respiratory distress syndrome. Am J Respir Crit Care Med 2000; 161 (05) 1590-1596
    CrossrefPubMedSearch in Google Scholar
  • 178 Koutsoukou A, Bekos B, Sotiropoulou C, Koulouris NG, Roussos C, Milic-Emili J. Effects of positive end-expiratory pressure on gas exchange and expiratory flow limitation in adult respiratory distress syndrome. Crit Care Med 2002; 30 (09) 1941-1949
    CrossrefPubMedSearch in Google Scholar
  • 179 Vieillard-Baron A, Prin S, Schmitt JM. et al. Pressure-volume curves in acute respiratory distress syndrome: clinical demonstration of the influence of expiratory flow limitation on the initial slope. Am J Respir Crit Care Med 2002; 165 (08) 1107-1112
    CrossrefPubMedSearch in Google Scholar
  • 180 Laghi F, Goyal A. Auto-PEEP in respiratory failure. Minerva Anestesiol 2012; 78 (02) 201-221
    PubMedSearch in Google Scholar
  • 181 Akoumianaki E, Maggiore SM, Valenza F. et al. PLUG Working Group (Acute Respiratory Failure Section of the European Society of Intensive Care Medicine). The application of esophageal pressure measurement in patients with respiratory failure. Am J Respir Crit Care Med 2014; 189 (05) 520-531
    CrossrefPubMedSearch in Google Scholar
  • 182 Talmor D, Sarge T, Malhotra A. et al. Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med 2008; 359 (20) 2095-2104
    Search in Google Scholar
  • 183 Baedorf Kassis E, Loring SH, Talmor D. Mortality and pulmonary mechanics in relation to respiratory system and transpulmonary driving pressures in ARDS. Intensive Care Med 2016; 42 (08) 1206-1213
    CrossrefPubMedSearch in Google Scholar
  • 184 Baedorf Kassis E, Loring SH, Talmor D. Should we titrate peep based on end-expiratory transpulmonary pressure?-yes. Ann Transl Med 2018; 6 (19) 390
    CrossrefPubMedSearch in Google Scholar
  • 185 Bugedo G, Retamal J, Bruhn A. Driving pressure: a marker of severity, a safety limit, or a goal for mechanical ventilation?. Crit Care 2017; 21 (01) 199
    CrossrefPubMedSearch in Google Scholar
  • 186 Hubmayr RD. Is there a place for esophageal manometry in the care of patients with injured lungs?. J Appl Physiol (1985) 2010; 108 (03) 481-482
    CrossrefPubMedSearch in Google Scholar
  • 187 Gattinoni L, Chiumello D, Carlesso E, Valenza F. Bench-to-bedside review: chest wall elastance in acute lung injury/acute respiratory distress syndrome patients. Crit Care 2004; 8 (05) 350-355
    CrossrefPubMedSearch in Google Scholar
  • 188 Staffieri F, Stripoli T, De Monte V. et al. Physiological effects of an open lung ventilatory strategy titrated on elastance-derived end-inspiratory transpulmonary pressure: study in a pig model*. Crit Care Med 2012; 40 (07) 2124-2131
    CrossrefPubMedSearch in Google Scholar
  • 189 Mauri T, Yoshida T, Bellani G. et al. PLeUral pressure working Group (PLUG—Acute Respiratory Failure section of the European Society of Intensive Care Medicine). Esophageal and transpulmonary pressure in the clinical setting: meaning, usefulness and perspectives. Intensive Care Med 2016; 42 (09) 1360-1373
    CrossrefPubMedSearch in Google Scholar
  • 190 Yoshida T, Amato MBP, Grieco DL. et al. Esophageal manometry and regional transpulmonary pressure in lung injury. Am J Respir Crit Care Med 2018; 197 (08) 1018-1026
    Search in Google Scholar
  • 191 Madahar P, Talmor D, Beitler JR. Transpulmonary pressure-guided ventilation to attenuate atelectrauma and hyperinflation in acute lung injury. Am J Respir Crit Care Med 2021; 203 (08) 934-937
    CrossrefPubMedSearch in Google Scholar
  • 192 Wilson TA. Solid mechanics. In: Handbook of Physiology: A Critical, Comprehensive Presentation of Physiological Knowledge and Concepts. American Physiological Society. Baltimore, MD: Waverly; 1986: 35-39
    Search in Google Scholar
  • 193 Pilkey WD. Formulas for Stress, Strain and Structural Matrices. 2nd ed.. Hoboken, New Jersey: John Wiley & Sons, Inc.; 2005: 89-143
    Search in Google Scholar
  • 194 Protti A, Votta E, Gattinoni L. Which is the most important strain in the pathogenesis of ventilator-induced lung injury: dynamic or static?. Curr Opin Crit Care 2014; 20 (01) 33-38
    CrossrefPubMedSearch in Google Scholar
  • 195 Liu M, Tanswell AK, Post M. Mechanical force-induced signal transduction in lung cells. Am J Physiol 1999; 277 (04) L667-L683
    PubMedSearch in Google Scholar
  • 196 Vlahakis NE, Schroeder MA, Pagano RE, Hubmayr RD. Deformation-induced lipid trafficking in alveolar epithelial cells. Am J Physiol Lung Cell Mol Physiol 2001; 280 (05) L938-L946
    CrossrefPubMedSearch in Google Scholar
  • 197 Pugin J. Molecular mechanisms of lung cell activation induced by cyclic stretch. Crit Care Med 2003; 31 (4, Suppl): S200-S206
    CrossrefPubMedSearch in Google Scholar
  • 198 Cressoni M, Cadringher P, Chiurazzi C. et al. Lung inhomogeneity in patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 2014; 189 (02) 149-158
    CrossrefPubMedSearch in Google Scholar
  • 199 Xin Y, Cereda M, Hamedani H. et al. Unstable inflation causing injury. Insight from prone position and paired computed tomography scans. Am J Respir Crit Care Med 2018; 198 (02) 197-207
    CrossrefPubMedSearch in Google Scholar
  • 200 Protti A, Cressoni M, Santini A. et al. Lung stress and strain during mechanical ventilation: any safe threshold?. Am J Respir Crit Care Med 2011; 183 (10) 1354-1362
    CrossrefPubMedSearch in Google Scholar
  • 201 Protti A, Andreis DT, Monti M. et al. Lung stress and strain during mechanical ventilation: any difference between statics and dynamics?. Crit Care Med 2013; 41 (04) 1046-1055
    CrossrefPubMedSearch in Google Scholar
  • 202 Suki B, Bates JHT. Lung tissue mechanics as an emergent phenomenon. J Appl Physiol (1985) 2011; 110 (04) 1111-1118
    CrossrefPubMedSearch in Google Scholar
  • 203 Brunner JX, Wysocki M. Is there an optimal breath pattern to minimize stress and strain during mechanical ventilation?. Intensive Care Med 2009; 35 (08) 1479-1483
    CrossrefPubMedSearch in Google Scholar
  • 204 Mentzelopoulos SD, Roussos C, Zakynthinos SG. Prone position reduces lung stress and strain in severe acute respiratory distress syndrome. Eur Respir J 2005; 25 (03) 534-544
    CrossrefPubMedSearch in Google Scholar
  • 205 Paula LF, Wellman TJ, Winkler T. et al. Regional tidal lung strain in mechanically ventilated normal lungs. J Appl Physiol (1985) 2016; 121 (06) 1335-1347
    CrossrefPubMedSearch in Google Scholar
  • 206 Chen L, Del Sorbo L, Grieco DL. et al. Airway closure in acute respiratory distress syndrome: an underestimated and misinterpreted phenomenon. Am J Respir Crit Care Med 2018; 197 (01) 132-136
    CrossrefPubMedSearch in Google Scholar
  • 207 Grieco DL, Anzellotti GM, Russo A. et al. Airway closure during surgical pneumoperitoneum in obese patients. Anesthesiology 2019; 131 (01) 58-73
    CrossrefPubMedSearch in Google Scholar
  • 208 Marini JJ, Rocco PRM, Gattinoni L. Static and dynamic contributors to ventilator-induced lung injury in clinical practice. Pressure, energy, and power. Am J Respir Crit Care Med 2020; 201 (07) 767-774
    CrossrefPubMedSearch in Google Scholar
  • 209 Otis AB, Fenn WO, Rahn H. Mechanics of breathing in man. J Appl Physiol 1950; 2 (11) 592-607
    CrossrefPubMedSearch in Google Scholar
  • 210 Rodarte JR, Rehder K. Dynamics of respiration. In: Macklem PT, Mead J, eds. Handbook of Physiology. Baltimore, MD: Williams & Wilkins; 1986: 131-144
    Search in Google Scholar
  • 211 Marini JJ, Crooke III PS. A general mathematical model for respiratory dynamics relevant to the clinical setting. Am Rev Respir Dis 1993; 147 (01) 14-24
    CrossrefPubMedSearch in Google Scholar
  • 212 Becher T, van der Staay M, Schädler D, Frerichs I, Weiler N. Calculation of mechanical power for pressure-controlled ventilation. Intensive Care Med 2019; 45 (09) 1321-1323
    CrossrefPubMedSearch in Google Scholar
  • 213 van der Meijden S, Molenaar M, Somhorst P, Schoe A. Calculating mechanical power for pressure-controlled ventilation. Intensive Care Med 2019; 45 (10) 1495-1497
    CrossrefPubMedSearch in Google Scholar
  • 214 Serpa Neto A, Deliberato RO, Johnson AEW. et al. PROVE Network Investigators. Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts. Intensive Care Med 2018; 44 (11) 1914-1922
    CrossrefPubMedSearch in Google Scholar
  • 215 Schuijt MTU, Schultz MJ, Paulus F, Serpa Neto A. PRoVENT–COVID Collaborative Group. Association of intensity of ventilation with 28-day mortality in COVID-19 patients with acute respiratory failure: insights from the PRoVENT-COVID study. Crit Care 2021; 25 (01) 283
    CrossrefPubMedSearch in Google Scholar
  • 216 Dianti J, Matelski J, Tisminetzky M. et al. Comparing the effects of tidal volume, driving pressure, and mechanical power on mortality in trials of lung-protective mechanical ventilation. Respir Care 2021; 66 (02) 221-227
    CrossrefPubMedSearch in Google Scholar
  • 217 Coppola S, Caccioppola A, Froio S. et al. Effect of mechanical power on intensive care mortality in ARDS patients. Crit Care 2020; 24 (01) 246
    CrossrefPubMedSearch in Google Scholar
  • 218 Collino F, Rapetti F, Vasques F. et al. Positive end-expiratory pressure and mechanical power. Anesthesiology 2019; 130 (01) 119-130
    CrossrefPubMedSearch in Google Scholar
  • 219 Briel M, Meade M, Mercat A. et al. Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA 2010; 303 (09) 865-873
    Search in Google Scholar
  • 220 Beitler JR, Walkey AJ. The staying power of pressure- and volume-limited ventilation in acute respiratory distress syndrome. Am J Respir Crit Care Med 2021; 204 (03) 247-249
    CrossrefPubMedSearch in Google Scholar
  • 221 Ranieri VM, Giuliani R, Fiore T, Dambrosio M, Milic-Emili J. Volume-pressure curve of the respiratory system predicts effects of PEEP in ARDS: “occlusion” versus “constant flow” technique. Am J Respir Crit Care Med 1994; 149 (01) 19-27
    CrossrefPubMedSearch in Google Scholar
  • 222 Grasso S, Terragni P, Mascia L. et al. Airway pressure-time curve profile (stress index) detects tidal recruitment/hyperinflation in experimental acute lung injury. Crit Care Med 2004; 32 (04) 1018-1027
    CrossrefPubMedSearch in Google Scholar
  • 223 Grasso S, Stripoli T, De Michele M. et al. ARDSnet ventilatory protocol and alveolar hyperinflation: role of positive end-expiratory pressure. Am J Respir Crit Care Med 2007; 176 (08) 761-767
    CrossrefPubMedSearch in Google Scholar
  • 224 Terragni PP, Filippini C, Slutsky AS. et al. Accuracy of plateau pressure and stress index to identify injurious ventilation in patients with acute respiratory distress syndrome. Anesthesiology 2013; 119 (04) 880-889
    CrossrefPubMedSearch in Google Scholar
  • 225 Gattinoni L, Taccone P, Carlesso E, Marini JJ. Prone position in acute respiratory distress syndrome. Rationale, indications, and limits. Am J Respir Crit Care Med 2013; 188 (11) 1286-1293
    CrossrefPubMedSearch in Google Scholar
  • 226 Gattinoni L, Pelosi P, Vitale G, Pesenti A, D'Andrea L, Mascheroni D. Body position changes redistribute lung computed-tomographic density in patients with acute respiratory failure. Anesthesiology 1991; 74 (01) 15-23
    CrossrefPubMedSearch in Google Scholar
  • 227 Gattinoni L, Pesenti A, Carlesso E. Body position changes redistribute lung computed-tomographic density in patients with acute respiratory failure: impact and clinical fallout through the following 20 years. Intensive Care Med 2013; 39 (11) 1909-1915
    Search in Google Scholar
  • 228 Bradley CA, Anthonisen NR. Rib cage and abdominal restrictions have different effects on lung mechanics. J Appl Physiol 1980; 49 (06) 946-952
    CrossrefPubMedSearch in Google Scholar
  • 229 Scheidt M, Hyatt RE, Rehder K. Effects of rib cage or abdominal restriction on lung mechanics. J Appl Physiol 1981; 51 (05) 1115-1121
    CrossrefPubMedSearch in Google Scholar
  • 230 Yoshida T, Engelberts D, Otulakowski G. et al. Continuous negative abdominal pressure: mechanism of action and comparison with prone position. J Appl Physiol (1985) 2018; 125 (01) 107-116
    CrossrefPubMedSearch in Google Scholar
  • 231 Rezoagli E, Bastia L, Grassi A. et al. Paradoxical effect of chest wall compression on respiratory system compliance: a multicenter case series of patients with ARDS, with multimodal assessment. Chest 2021; 160 (04) 1335-1339
    CrossrefPubMedSearch in Google Scholar
  • 232 Carteaux G, Tuffet S, Mekontso Dessap A. Potential protective effects of continuous anterior chest compression in the acute respiratory distress syndrome: physiology of an illustrative case. Crit Care 2021; 25 (01) 187
    CrossrefPubMedSearch in Google Scholar
  • 233 Bottino N, Panigada M, Chiumello D. et al. Effects of artificial changes in chest wall compliance on respiratory mechanics and gas exchange in patients with acute lung injury (ALI). Crit Care 2000; 4: 117
    CrossrefPubMedSearch in Google Scholar
  • 234 Samanta S, Samanta S, Soni KD. Supine chest compression: alternative to prone ventilation in acute respiratory distress syndrome. Am J Emerg Med 2014; 32 (05) 489.e5-489.e6
    CrossrefPubMedSearch in Google Scholar
  • 235 Kummer RL, Shapiro RS, Marini JJ, Huelster JS, Leatherman JW. Paradoxically improved respiratory compliance with abdominal compression in COVID-19 ARDS. Chest 2021; 160 (05) 1739-1742
    CrossrefPubMedSearch in Google Scholar
  • 236 Stavi D, Goffi A, Al Shalabi M. et al. The pressure paradox: abdominal compression to detect lung hyper-inflation in COVID-19 ARDS. Am J Respir Crit Care Med 2022; 205 (02) 245-247
    CrossrefPubMedSearch in Google Scholar
  • 237 Keenan JC, Cortes-Puentes GA, Zhang L, Adams AB, Dries DJ, Marini JJ. PEEP titration: the effect of prone position and abdominal pressure in an ARDS model. Intensive Care Med Exp 2018; 6 (01) 3
    CrossrefPubMedSearch in Google Scholar
  • 238 Dellamonica J, Lerolle N, Sargentini C. et al. Effect of different seated positions on lung volume and oxygenation in acute respiratory distress syndrome. Intensive Care Med 2013; 39 (06) 1121-1127
    CrossrefPubMedSearch in Google Scholar
  • 239 Roldán R, Rodriguez S, Barriga F. et al. Sequential lateral positioning as a new lung recruitment maneuver: an exploratory study in early mechanically ventilated Covid-19 ARDS patients. Ann Intensive Care 2022; 12 (01) 13
    CrossrefPubMedSearch in Google Scholar
  • 240 Marini JJ, Gattinoni L. Improving lung compliance by external compression of the chest wall. Crit Care 2021; 25 (01) 264
    CrossrefPubMedSearch in Google Scholar
  • 241 Cereda M, Xin Y, Goffi A. et al. Imaging the injured lung: mechanisms of action and clinical use. Anesthesiology 2019; 131 (03) 716-749
    CrossrefPubMedSearch in Google Scholar
  • 242 Pesenti A, Musch G, Lichtenstein D. et al. Imaging in acute respiratory distress syndrome. Intensive Care Med 2016; 42 (05) 686-698
    CrossrefPubMedSearch in Google Scholar
  • 243 Musch G. New frontiers in functional and molecular imaging of the acutely injured lung: pathophysiological insights and research applications. Front Physiol 2021; 12: 762688
    CrossrefPubMedSearch in Google Scholar
  • 244 Frerichs I, Amato MB, van Kaam AH. et al. TREND Study Group. Chest electrical impedance tomography examination, data analysis, terminology, clinical use and recommendations: consensus statement of the TRanslational EIT developmeNt stuDy group. Thorax 2017; 72 (01) 83-93
    CrossrefPubMedSearch in Google Scholar
  • 245 Biederer J, Mirsadraee S, Beer M. et al. MRI of the lung (3/3)-current applications and future perspectives. Insights Imaging 2012; 3 (04) 373-386
    CrossrefPubMedSearch in Google Scholar
  • 246 Cereda M, Xin Y, Kadlecek S. et al. Hyperpolarized gas diffusion MRI for the study of atelectasis and acute respiratory distress syndrome. NMR Biomed 2014; 27 (12) 1468-1478
    CrossrefPubMedSearch in Google Scholar
  • 247 Lichtenstein DA. Lung ultrasound in the critically ill. Ann Intensive Care 2014; 4 (01) 1
    CrossrefPubMedSearch in Google Scholar
  • 248 Robba C, Wong A, Poole D. et al. European Society of Intensive Care Medicine task force for critical care ultrasonography*. Basic ultrasound head-to-toe skills for intensivists in the general and neuro intensive care unit population: consensus and expert recommendations of the European Society of Intensive Care Medicine. Intensive Care Med 2021; 47 (12) 1347-1367
    CrossrefPubMedSearch in Google Scholar
  • 249 Maddali MV, Churpek M, Pham T. et al. Machine learning clinical-classifier models identify ARDS subphenotypes in observational cohorts and with differential responses to PEEP. Lancet Respir Med 2022; 10 (04) 367-377
    PubMedSearch in Google Scholar
  • 250 Constantin JM, Jabaudon M, Lefrant JY. et al. AZUREA Network. Personalised mechanical ventilation tailored to lung morphology versus low positive end-expiratory pressure for patients with acute respiratory distress syndrome in France (the LIVE study): a multicentre, single-blind, randomised controlled trial. Lancet Respir Med 2019; 7 (10) 870-880
    CrossrefPubMedSearch in Google Scholar
  • 251 West JB, Luks AM. eds. Ventilation-perfusion relationships: how matching of gas and blood determines gas exchange. In: West's Respiratory Physiology: The Essentials. 11th ed.. Wolters Kluwer Health; 2020
    Search in Google Scholar