Respiratory failure & ventilation
Impact of Respiratory Effort Parameters on Clinical Outcomes in Respiratory Failure Patients (Effort-I): A Prospective Observational Study
Authors' conclusion
Early respiratory drive and inspiratory effort within preferred physiological ranges were associated with more VFDs and lower mortality. Calculated ΔPL showed the strongest association with adverse outcomes
Study context
- Population
- Adults aged 18–75 years with acute respiratory failure requiring invasive mechanical ventilation and PaO2/FiO2 >150 mmHg, enrolled within 24 h of ICU admission
- Participants
- 206 adults
- Exposure
- Preferred range vs Low or high values
- Outcome
- Ventilator-free days (VFDs)
- Follow-up
- 28 days
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
28-day VFDs
- Patients within preferred ranges had more 28-day ventilator-free days (VFDs) than those with low or high values
- Low and high P0.1, low calculated Pmus and high calculated ΔPL independently associated with fewer VFDs (multivariable Poisson regression)
Observational data: associations, not effects.
Secondary outcomes
28-day mortality, calculated ΔPL >20 cmH2O
| HR (95% CI) | P value | ||
|---|---|---|---|
| ΔPL >20 cmH2O | 6.57 (2.29–18.86) | P < 0.001 | |
| 0.050.21520Hazard ratio (log scale) |
28-day mortality, low and high P0.1
| HR | |
|---|---|
| Low P0.1 | 3.75 |
| High P0.1 | 4.81 |
- 28-day mortality, calculated ΔPL >20 cmH2O: multivariable Cox regression adjusted for age, immunocompromised status, peak airway pressure, APACHE II score
Oxygenation
- Oxygenation improved with preferred effort levels; ΔPL >20 cmH2O associated with new-onset hypoxemia
Correlation with RASS scores
- Calculated Pmus
- r = 0.76
- P0.1
- r = 0.50
- ΔPL
- r = 0.43
Original publication
Impact of Respiratory Effort Parameters on Clinical Outcomes in Respiratory Failure Patients (Effort-I): A Prospective Observational Study. Ann Intensive Care. Published 20 June 2026. doi:10.
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