{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T16:13:55Z","timestamp":1780330435104,"version":"3.54.1"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>While proportional ventilator modes have gained popularity in adult patients\u2019 ventilatory management, Proportional Assist Ventilation (PAV+) use in pediatric patients with Pediatric Acute Respiratory Distress Syndrome (PARDS) remains unexplored. This study aims to evaluate the effects of optimized PSV and PAV+ on patient\u2010ventilator interaction and respiratory pattern in two pediatric simulated lung models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study utilized an active lung simulator to replicate two pediatric lung models: one healthy and one with mild PARDS. Each model was ventilated using PAV+ and optimized PSV at four different levels, assessing simulated patient\u2010ventilator interaction and mechanical response to increase inspiratory effort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In terms of simulated patient\u2010ventilator interaction, in a healthy and mild PARDS lung model and all setting tested, the optimized PSV presented the better patient\u2010ventilator interaction with the shortest values of Inspiratory trigger delay (Delay<jats:sub>trinsp<\/jats:sub>), Pressurization time (Time<jats:sub>press<\/jats:sub>) and Expiratory trigger delay (Delay<jats:sub>trexp<\/jats:sub>) and the highest values of Synchrony time (Time<jats:sub>synch<\/jats:sub>). Only in the lung model with PARDS, during high assistance levels and high Pmus, no significant differences were found in terms of patient ventilation interaction between the two modalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In a healthy lung model, optimized PSV allows optimal simulated patient\u2010ventilator interaction and assistance levels compared to PAV+. On the contrary, in a simulated lung with mild PARDS, PAV+ appears as a valid alternative to PSV, especially under conditions of intense inspiratory effort and high assistance levels.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.71027","type":"journal-article","created":{"date-parts":[[2025,3,8]],"date-time":"2025-03-08T08:05:01Z","timestamp":1741421101000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["\u201cEvaluation of Different Inspiratory Efforts in a Pediatric Model of Healthy Lung and Pediatric Acute Respiratory Distress Syndrome During Optimized Pressure Support Ventilation and Proportional Assist Ventilation Plus (PAV+): A Bench Study"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8055-5142","authenticated-orcid":false,"given":"G.","family":"Spinazzola","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Ferrone","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Festa","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Hospital General Sant Joan de Deu Sant Boi Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Piastra","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy"},{"name":"Catholic University of Sacred Heart Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Bello","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. F.","family":"Amato","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Rossi","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy"},{"name":"Catholic University of Sacred Heart Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8566-9365","authenticated-orcid":false,"given":"G.","family":"Conti","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy"},{"name":"Catholic University of Sacred Heart Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.07284"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000089939.11032.36"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000287594.80110.34"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199111000-00009"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-015-3692-6"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-006-0301-8"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40635-019-0234-5"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000525604"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/9055587"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.38189"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.51230"},{"key":"e_1_2_9_13_1","first-page":"19","article-title":"Respiratory Mechanical Unloading and Proportional Assist Ventilation in Infants","volume":"1","author":"Schulze A.","year":"2007","journal-title":"Acta Paediatrica"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.159.6.9704025"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.159.5.9804130"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199701000-00012"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1996.80.2.397"},{"key":"e_1_2_9_18_1","first-page":"349","volume-title":"Principles and Practice of Mechanical Ventilation","author":"Younes M.","year":"1994"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001340051001"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.155.6.9196100"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.154.5.8912744"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1996.81.1.426"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001340050954"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(99)70131-9"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-020-02227-1"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000910"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-017-1761-7"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2021.11.010"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-015-0763-6"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-021-00958-7"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(99)70131-9"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1159\/000098376"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-011-2297-y"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2013-305817"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-006-0110-0"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71027","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T07:43:40Z","timestamp":1748245420000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.71027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":34,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1002\/ppul.71027"],"URL":"https:\/\/doi.org\/10.1002\/ppul.71027","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]},"assertion":[{"value":"2024-08-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71027"}}