Impact of inspiratory pressure rise time on lung-emptying in time controlled adaptive ventilation
Background: The airway pressure release ventilation (APRV)-based time controlled adaptive ventilation (TCAV) protocol can potentially minimize ventilator-induced lung injury (VILI). Inspiratory pressure rise time (IPRT) is a parameter available in pressure-controlled ventilation modes, yet its role...
Gespeichert in:
| Hauptverfasser: | , , , , , , , , |
|---|---|
| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
2025
|
| In: |
Respiratory care
Year: 2025, Jahrgang: 70, Heft: 12, Pages: 1547-1555 |
| ISSN: | 1943-3654 |
| DOI: | 10.1177/19433654251359959 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1177/19433654251359959 Verlag, lizenzpflichtig, Volltext: https://www.liebertpub.com/doi/10.1177/19433654251359959 
|
| Verfasserangaben: | Benjamin Neetz, Patrick Rehn, Nicole Kraus, Werner Schmidt, Lars Reinhardt, Thomas Flohr, Christoph Laußer, Markus Alexander Weigand, Mascha O. Fiedler-Kalenka |
MARC
| LEADER | 00000naa a22000002c 4500 | ||
|---|---|---|---|
| 001 | 1946305790 | ||
| 003 | DE-627 | ||
| 005 | 20251217110323.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 251217s2025 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1177/19433654251359959 |2 doi | |
| 035 | |a (DE-627)1946305790 | ||
| 035 | |a (DE-599)KXP1946305790 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rda | ||
| 041 | |a eng | ||
| 084 | |a 33 |2 sdnb | ||
| 100 | 1 | |a Neetz, Benjamin |e VerfasserIn |0 (DE-588)1286793262 |0 (DE-627)1843397862 |4 aut | |
| 245 | 1 | 0 | |a Impact of inspiratory pressure rise time on lung-emptying in time controlled adaptive ventilation |c Benjamin Neetz, Patrick Rehn, Nicole Kraus, Werner Schmidt, Lars Reinhardt, Thomas Flohr, Christoph Laußer, Markus Alexander Weigand, Mascha O. Fiedler-Kalenka |
| 264 | 1 | |c 2025 | |
| 300 | |a 9 | ||
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Online veröffentlicht: 25. August 2025 | ||
| 500 | |a Gesehen am 17.12.2025 | ||
| 520 | |a Background: The airway pressure release ventilation (APRV)-based time controlled adaptive ventilation (TCAV) protocol can potentially minimize ventilator-induced lung injury (VILI). Inspiratory pressure rise time (IPRT) is a parameter available in pressure-controlled ventilation modes, yet its role within TCAV remains unclear. We hypothesized that varying IPRTs impact lung emptying and associated ventilatory parameters (driving pressure [ΔP], intrinsic PEEP [PEEPi], exhaled tidal volume [VTe]). - Methods: This single-center, prospective exploratory study included 10 intubated subjects ventilated utilizing the TCAV protocol. Subjects underwent consecutive experimental trials with IPRTs of 500 and 1,000 ms, each preceded by a baseline (BL) with an IPRT of 0 ms. Analyzed parameters were ventilator-derived ΔP (ΔPvent), PEEPi, and VTe. Elastance (ERS = ΔPvent/VTe) and elastance-derived ΔP (ΔPelast = ERS × VTe) were calculated. End-expiratory lung volume (EELV) and end-inspiratory lung volume were assessed through electrical impedance tomography (EIT). - Results: Prolonged IPRT increased ΔPelast compared with ΔPvent in each baseline/trial combination (ΔPvent 13.5 ± 1.5 cm H2O vs ΔPelast 18.4 ± 2.7 cm H2O at 1,000 ms IPRT, P < .001) through a loss of PEEPi. Conventional PEEPi measurements did not detect these changes. The EIT data showed a reduction in EELV during the trials. - Conclusions: IPRT prolongation under TCAV reduced EELV/PEEPi, therefore increasing ΔP. Conventional PEEPi measurement methods are misleading in this context. We therefore suggest adding the recommendation to set IPRT to 0 ms for the TCAV protocol. | ||
| 700 | 1 | |a Rehn, Patrick |e VerfasserIn |0 (DE-588)1255672242 |0 (DE-627)1799754995 |4 aut | |
| 700 | 1 | |a Kraus, Nicole |e VerfasserIn |4 aut | |
| 700 | 1 | |a Schmidt, Werner |e VerfasserIn |0 (DE-588)1078173079 |0 (DE-627)838124852 |0 (DE-576)449039641 |4 aut | |
| 700 | 1 | |a Reinhardt, Lars |d 1981- |e VerfasserIn |0 (DE-588)138359016 |0 (DE-627)601634527 |0 (DE-576)307285057 |4 aut | |
| 700 | 1 | |a Flohr, Thomas |e VerfasserIn |4 aut | |
| 700 | 1 | |a Laußer, Christoph |e VerfasserIn |4 aut | |
| 700 | 1 | |a Weigand, Markus A. |d 1967- |e VerfasserIn |0 (DE-588)1064970435 |0 (DE-627)815375239 |0 (DE-576)424658666 |4 aut | |
| 700 | 1 | |a Fiedler-Kalenka, Mascha |d 1979- |e VerfasserIn |0 (DE-588)1018788603 |0 (DE-627)683425951 |0 (DE-576)356370283 |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Respiratory care |d Dallas, Tex. : Daedalus Enterprises, 1997 |g 70(2025), 12, Seite 1547-1555 |h Online-Ressource |w (DE-627)363756884 |w (DE-600)2106236-5 |w (DE-576)357959531 |x 1943-3654 |7 nnas |a Impact of inspiratory pressure rise time on lung-emptying in time controlled adaptive ventilation |
| 773 | 1 | 8 | |g volume:70 |g year:2025 |g number:12 |g pages:1547-1555 |g extent:9 |a Impact of inspiratory pressure rise time on lung-emptying in time controlled adaptive ventilation |
| 856 | 4 | 0 | |u https://doi.org/10.1177/19433654251359959 |x Verlag |x Resolving-System |z lizenzpflichtig |3 Volltext |7 1 |
| 856 | 4 | 0 | |u https://www.liebertpub.com/doi/10.1177/19433654251359959 |x Verlag |z lizenzpflichtig |3 Volltext |7 1 |
| 951 | |a AR | ||
| 992 | |a 20251217 | ||
| 993 | |a Article | ||
| 994 | |a 2025 | ||
| 998 | |g 1018788603 |a Fiedler-Kalenka, Mascha |m 1018788603:Fiedler-Kalenka, Mascha |d 910000 |d 910300 |d 50000 |e 910000PF1018788603 |e 910300PF1018788603 |e 50000PF1018788603 |k 0/910000/ |k 1/910000/910300/ |k 0/50000/ |p 9 |y j | ||
| 998 | |g 1064970435 |a Weigand, Markus A. |m 1064970435:Weigand, Markus A. |d 910000 |d 910300 |e 910000PW1064970435 |e 910300PW1064970435 |k 0/910000/ |k 1/910000/910300/ |p 8 | ||
| 998 | |g 138359016 |a Reinhardt, Lars |m 138359016:Reinhardt, Lars |d 910000 |d 910300 |e 910000PR138359016 |e 910300PR138359016 |k 0/910000/ |k 1/910000/910300/ |p 5 | ||
| 998 | |g 1078173079 |a Schmidt, Werner |m 1078173079:Schmidt, Werner |d 50000 |e 50000PS1078173079 |k 0/50000/ |p 4 | ||
| 998 | |g 1255672242 |a Rehn, Patrick |m 1255672242:Rehn, Patrick |d 910000 |d 910300 |e 910000PR1255672242 |e 910300PR1255672242 |k 0/910000/ |k 1/910000/910300/ |p 2 | ||
| 999 | |a KXP-PPN1946305790 |e 4829574364 | ||
| BIB | |a Y | ||
| SER | |a journal | ||
| JSO | |a {"id":{"doi":["10.1177/19433654251359959"],"eki":["1946305790"]},"name":{"displayForm":["Benjamin Neetz, Patrick Rehn, Nicole Kraus, Werner Schmidt, Lars Reinhardt, Thomas Flohr, Christoph Laußer, Markus Alexander Weigand, Mascha O. Fiedler-Kalenka"]},"physDesc":[{"extent":"9 S."}],"recId":"1946305790","type":{"bibl":"article-journal","media":"Online-Ressource"},"language":["eng"],"note":["Online veröffentlicht: 25. August 2025","Gesehen am 17.12.2025"],"title":[{"title":"Impact of inspiratory pressure rise time on lung-emptying in time controlled adaptive ventilation","title_sort":"Impact of inspiratory pressure rise time on lung-emptying in time controlled adaptive ventilation"}],"origin":[{"dateIssuedKey":"2025","dateIssuedDisp":"2025"}],"relHost":[{"physDesc":[{"extent":"Online-Ressource"}],"recId":"363756884","disp":"Impact of inspiratory pressure rise time on lung-emptying in time controlled adaptive ventilationRespiratory care","pubHistory":["Nachgewiesen 42.1997,10 -"],"origin":[{"publisher":"Daedalus Enterprises","publisherPlace":"Dallas, Tex.","dateIssuedKey":"1997","dateIssuedDisp":"1997-"}],"note":["Gesehen am 26.11.24","Fortsetzung der Druck-Ausgabe"],"language":["eng"],"type":{"media":"Online-Ressource","bibl":"periodical"},"part":{"volume":"70","year":"2025","issue":"12","extent":"9","text":"70(2025), 12, Seite 1547-1555","pages":"1547-1555"},"title":[{"subtitle":"the official journal of the American Association for Respiratory Care","title_sort":"Respiratory care","title":"Respiratory care"}],"id":{"eki":["363756884"],"issn":["1943-3654"],"zdb":["2106236-5"]}}],"person":[{"display":"Neetz, Benjamin","family":"Neetz","role":"aut","given":"Benjamin"},{"family":"Rehn","role":"aut","given":"Patrick","display":"Rehn, Patrick"},{"display":"Kraus, Nicole","role":"aut","given":"Nicole","family":"Kraus"},{"display":"Schmidt, Werner","family":"Schmidt","role":"aut","given":"Werner"},{"family":"Reinhardt","given":"Lars","role":"aut","display":"Reinhardt, Lars"},{"display":"Flohr, Thomas","family":"Flohr","role":"aut","given":"Thomas"},{"display":"Laußer, Christoph","family":"Laußer","given":"Christoph","role":"aut"},{"display":"Weigand, Markus A.","given":"Markus A.","role":"aut","family":"Weigand"},{"display":"Fiedler-Kalenka, Mascha","given":"Mascha","role":"aut","family":"Fiedler-Kalenka"}]} | ||
| SRT | |a NEETZBENJAIMPACTOFIN2025 | ||