{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:58:30Z","timestamp":1787241510408,"version":"build-2736575974"},"reference-count":32,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respiratory Care"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The impact of spontaneous breathing during mechanical ventilation on the outcome of ARDS has yet to be established. This study aimed to evaluate the effect of tidal volume variability on ventilator-free days in mechanically ventilated subjects with ARDS using high-resolution tidal volume data collected through patient monitors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This single-center, retrospective cohort study included adult subjects with ARDS who received mechanical ventilation in our medical ICU between April 2018 and July 2019. The study subjects\u2019 expiratory tidal volume data during the first 7\u2009days of mechanical ventilation were collected every 2\u2009s from the patient monitors. The subjects were divided equally into 3 groups according to the coefficient of variation (CV) of all collected normalized tidal volume values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 108 subjects with ARDS were categorized into the low, intermediate, and high CV groups (each number\n                      <jats:italic toggle=\"yes\">=<\/jats:italic>\n                      36). Baseline characteristics of the 3 groups were comparable except for a lower P\n                      <jats:sub>\n                        aO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      \/F\n                      <jats:sub>\n                        IO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      in the low CV group (130 \u00b1 50\u2009mm\u2009Hg vs 160 \u00b1 57\u2009mm\u2009Hg vs 158 \u00b1 50\u2009mm\u2009Hg, P = .03). On average, 222,776 tidal volume data points were collected per subject during the first 7\u2009days of mechanical ventilation. The CVs of tidal volume were 17% \u00b1 3%, 26% \u00b1 2%, and 38% \u00b1 8% in each group, respectively. The number of ventilator-free days was significantly lower in the high CV group than in the intermediate CV group (0 [interquartile range or IQR, 0\u20132.5] days vs 16 [IQR, 0\u201321.5] days,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .004 after Bonferroni correction). After adjusting in the zero-inflated negative binomial model, high CV was significantly associated with fewer ventilator-free days compared with intermediate CV (odds ratio, 11.1, 95% CI [2.3\u201352.7],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Based on the high-resolution tidal volume data from the ventilator monitors, high tidal volume variability during the first 7\u2009days of mechanical ventilation in subjects with ARDS was associated with fewer ventilator-free days.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/respcare.12930","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T18:58:41Z","timestamp":1748372321000},"page":"1367-1375","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["High Tidal Volume Variability Is Associated With Worse Outcomes in Patients With ARDS"],"prefix":"10.1177","volume":"70","author":[{"given":"Jee Hwan","family":"Ahn","sequence":"first","affiliation":[{"name":"Drs. Ahn, Hong, Lim, and Huh are affiliated with Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Bum","family":"Hong","sequence":"additional","affiliation":[{"name":"Drs. Ahn, Hong, Lim, and Huh are affiliated with Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chae-Man","family":"Lim","sequence":"additional","affiliation":[{"name":"Drs. Ahn, Hong, Lim, and Huh are affiliated with Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Won","family":"Huh","sequence":"additional","affiliation":[{"name":"Drs. Ahn, Hong, Lim, and Huh are affiliated with Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.5669"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-022-00615-6"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0291"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-020-00464-1"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1005372"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02237"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-017-0324-z"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-018-5091-2"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.10550770"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-016-4470-9"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201705-0989OC"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202005-1582LE"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201804-0692OC"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.03887"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.164.1.2001078"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ccm.0000163226.34868.0a"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201503-0620OC"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-017-4912-z"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003519"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.21037\/atm-20-7901"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201604-0748CP"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201703-0536OC"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182451c40"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201303-0539OC"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201706-1244OC"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202308-1358OC"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-016-4423-3"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-015-3692-6"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-021-00565-5"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201610-1972OC"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-018-5045-8"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-023-00671-6"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/respcare.12930","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/respcare.12930","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/respcare.12930","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T10:34:00Z","timestamp":1787135640000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/respcare.12930"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,28]]},"references-count":32,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1089\/respcare.12930"],"URL":"https:\/\/doi.org\/10.1089\/respcare.12930","relation":{},"ISSN":["1943-3654","1943-3654"],"issn-type":[{"value":"1943-3654","type":"print"},{"value":"1943-3654","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,28]]}}}