Respiratory failure & ventilation
Influence of ventilatory settings on pendelluft and expiratory muscle activity in hypoxemic patients resuming spontaneous breathing
Authors' conclusion
In patients with ARDS transitioning to spontaneous breathing, increasing PS reduces pendelluft and expiratory muscle activity. Higher PEEP can decrease pendelluft, but its effect can be counteracted by increased expiratory activity.
Study context
- Population
- Hypoxemic patients recovering spontaneous breathing after ≥ 72 h of lung-protective, fully controlled mechanical ventilation (MV)6 females
- Participants
- 15 patients
- Comparison
- PS 5, 10 and 15 cmH₂O; PEEPEIT vs PEEPARDS
- Primary endpoint
- Pendelluft (% of volume displaced from non-dependent to dependent lung regions during inspiration) and expiratory muscle activity (ΔPgaEXP)
Methodological detailsrandomized crossover
- Randomized crossover
Primary result
As reported in the abstract
Pendelluft and ΔPgaEXP
PEEPEIT
11
median · IQR 10–13 · cmH₂O
PEEPARDS
6
median · IQR 5–7 · cmH₂O
PS 10 and 15 vs PS 5: P < 0.001 · PEEPEIT vs PEEPARDS: P = 0.039 · PEEPEIT vs PEEPARDS: P = 0.007
- Expiratory muscle activity observed
- 13 patients
Further findings
Mediation analysis
- Significant negative mediating effect of ΔPgaEXP on PEEPEIT–pendelluft relationship
- P < 0.001
- Pmus associated with pendelluft magnitude
- P < 0.001
- Pmus mediated effect of PS on reducing pendelluft
- P = 0.048
- Pmus did not mediate effect of positive end-expiratory pressure (PEEP)
- P = 0.46
Original publication
Influence of ventilatory settings on pendelluft and expiratory muscle activity in hypoxemic patients resuming spontaneous breathing. Crit Care. Published 3 December 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →