{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T18:36:45Z","timestamp":1772908605515,"version":"3.50.1"},"reference-count":68,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T00:00:00Z","timestamp":1605830400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T00:00:00Z","timestamp":1605830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pressure support ventilation (PSV) should allow spontaneous breathing with a \u201cnormal\u201d neuro-ventilatory drive. Low neuro-ventilatory drive puts the patient at risk of diaphragmatic atrophy while high neuro-ventilatory drive may causes dyspnea and patient self-inflicted lung injury. We continuously assessed for 12\u00a0h the electrical activity of the diaphragm (EAdi), a close surrogate of neuro-ventilatory drive, during PSV. Our aim was to document the EAdi trend and the occurrence of periods of \u201cLow\u201d and\/or \u201cHigh\u201d neuro-ventilatory drive during clinical application of PSV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      In 16 critically ill patients ventilated in the PSV mode for clinical reasons, inspiratory peak EAdi peak (EAdi\n                      <jats:sub>PEAK<\/jats:sub>\n                      ), pressure time product of the trans-diaphragmatic pressure per breath and per minute (PTP\n                      <jats:sub>DI\/b<\/jats:sub>\n                      and PTP\n                      <jats:sub>DI\/min<\/jats:sub>\n                      , respectively), breathing pattern and major asynchronies were continuously monitored for 12\u00a0h (from 8 a.m. to 8 p.m.). We identified breaths with \u201cNormal\u201d (EAdi\n                      <jats:sub>PEAK<\/jats:sub>\n                      5\u201315\u00a0\u03bcV), \u201cLow\u201d (EAdi\n                      <jats:sub>PEAK<\/jats:sub>\n                      \u2009&lt;\u20095\u00a0\u03bcV) and \u201cHigh\u201d (EAdi\n                      <jats:sub>PEAK<\/jats:sub>\n                      \u2009&gt;\u200915\u00a0\u03bcV) neuro-ventilatory drive.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Within all the analyzed breaths (177.117), the neuro-ventilatory drive, as expressed by the EAdi\n                      <jats:sub>PEAK<\/jats:sub>\n                      , was \u201cLow\u201d in 50.116 breath (28%), \u201cNormal\u201d in 88.419 breaths (50%) and \u201cHigh\u201d in 38.582 breaths (22%). The average times spent in \u201cLow\u201d, \u201cNormal\u201d and \u201cHigh\u201d class were 1.37, 3.67 and 0.55\u00a0h, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), with wide variations among patients. Eleven patients remained in the \u201cLow\u201d neuro-ventilatory drive class for more than 1\u00a0h, median 6.1 [3.9\u20138.5]\u00a0h and 6 in the \u201cHigh\u201d neuro-ventilatory drive class, median 3.4 [2.2\u20137.8]\u00a0h. The asynchrony index was significantly higher in the \u201cLow\u201d neuro-ventilatory class, mainly because of a higher number of missed efforts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We observed wide variations in EAdi amplitude and unevenly distributed \u201cLow\u201d and \u201cHigh\u201d neuro ventilatory drive periods during 12\u00a0h of PSV in critically ill patients. Further studies are needed to assess the possible clinical implications of our physiological findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13054-020-03357-9","type":"journal-article","created":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T02:03:20Z","timestamp":1605837800000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Continuous assessment of neuro-ventilatory drive during 12\u00a0h of pressure support ventilation in critically ill patients"],"prefix":"10.1186","volume":"24","author":[{"given":"Rosa","family":"Di mussi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Savino","family":"Spadaro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo Alberto","family":"Volta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Bartolomeo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Trerotoli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Staffieri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Pisani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachele","family":"Iannuzziello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lidia","family":"Dalfino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Murgolo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0287-0232","authenticated-orcid":false,"given":"Salvatore","family":"Grasso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,11,20]]},"reference":[{"key":"3357_CR1","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1097\/00075198-200202000-00009","volume":"8","author":"C Putensen","year":"2002","unstructured":"Putensen C, Hering R, Wrigge H. Controlled versus assisted mechanical ventilation. Curr Opin Crit Care. 2002;8:51\u20137.","journal-title":"Curr Opin Crit Care"},{"key":"3357_CR2","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1097\/01.ccx.0000198994.37319.60","volume":"12","author":"C Putensen","year":"2006","unstructured":"Putensen C, Muders T, Varelmann D, Wrigge H. The impact of spontaneous breathing during mechanical ventilation. Curr Opin Crit Care. 2006;12:13\u20138.","journal-title":"Curr Opin Crit Care."},{"key":"3357_CR3","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1164\/ajrccm.163.5.2005125","volume":"163","author":"MJ Tobin","year":"2001","unstructured":"Tobin MJ, Jubran A, Laghi F. Critical care perspective patient\u2014ventilator interaction. Am J Respir Crit Care Med. 2001;163:1059\u201363.","journal-title":"Am J Respir Crit Care Med"},{"key":"3357_CR4","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1164\/rccm.200706-893OC","volume":"177","author":"A Esteban","year":"2008","unstructured":"Esteban A, Ferguson ND, Meade MO, Frutos-Vivar F, Apezteguia C, Brochard L, et al. Evolution of mechanical ventilation in response to clinical research. Am J Respir Crit Care Med. 2008;177:170\u20137.","journal-title":"Am J Respir Crit Care Med"},{"key":"3357_CR5","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1378\/chest.89.5.677","volume":"89","author":"NR MacIntyre","year":"1986","unstructured":"MacIntyre NR. Respiratory function during pressure support ventilation. Chest [Internet]. 1986;89:677\u201383.","journal-title":"Chest [Internet]"},{"key":"3357_CR6","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1164\/ajrccm\/136.2.411","volume":"136","author":"L Brochard","year":"1987","unstructured":"Brochard L, Pluskwa F, Lemaire F. Improved efficacy of spontaneous breathing with inspiratory pressure support. Am Rev Respir Dis. 1987;136:411\u20135.","journal-title":"Am Rev Respir Dis"},{"key":"3357_CR7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-015-1178-0","volume":"20","author":"R Di Mussi","year":"2016","unstructured":"Di Mussi R, Spadaro S, Mirabella L, Volta CA, Serio G, Staffieri F, et al. Impact of prolonged assisted ventilation on diaphragmatic efficiency: NAVA versus PSV. Crit Care [Internet]. 2016;20:1\u201312.","journal-title":"Crit Care [Internet]"},{"issue":"1","key":"3357_CR8","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1164\/rccm.201903-0596SO","volume":"201","author":"K Vaporidi","year":"2020","unstructured":"Vaporidi K, Akoumianaki E, Telias I, Goligher EC, Brochard L, Georgopoulos D. Respiratory drive in critically ill patients pathophysiology and clinical implications. Am J Respir Crit Care Med. 2020;201(1):20\u201332.","journal-title":"Am J Respir Crit Care Med"},{"key":"3357_CR9","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1164\/rccm.201004-0670OC","volume":"183","author":"S Jaber","year":"2011","unstructured":"Jaber S, Petrof BJ, Jung B, Chanques G, Berthet JP, Rabuel C, et al. Rapidly progressive diaphragmatic weakness and injury during mechanical ventilation in humans. Am J Respir Crit Care Med. 2011;183:364\u201371.","journal-title":"Am J Respir Crit Care Med"},{"issue":"4","key":"3357_CR10","doi-asserted-by":"publisher","first-page":"1254","DOI":"10.1097\/CCM.0b013e31823c8cc9","volume":"40","author":"MB Hudson","year":"2012","unstructured":"Hudson MB, Smuder AJ, Nelson WB, Bruells CS, Levine S, Powers SK. Both high level pressure support ventilation and controlled mechanical ventilation induce diaphragm dysfunction and atrophy. Crit Care Med. 2012;40(4):1254\u201360.","journal-title":"Crit Care Med"},{"issue":"3","key":"3357_CR11","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1164\/rccm.202006-2157CP","volume":"202","author":"MJ Tobin","year":"2020","unstructured":"Tobin MJ, Laghi F, Jubran A. Why COVID-19 silent hypoxemia is baffling to physicians. Am J Respir Crit Care Med. 2020;202(3):356\u201360.","journal-title":"Am J Respir Crit Care Med."},{"issue":"4","key":"3357_CR12","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1164\/rccm.201605-1081CP","volume":"195","author":"L Brochard","year":"2017","unstructured":"Brochard L, Slutsky A, Pesenti A. Mechanical ventilation to minimize progression of lung injury in acute respiratory failure. Am J Respir Crit Care Med. 2017;195(4):438\u201342.","journal-title":"Am J Respir Crit Care Med"},{"key":"3357_CR13","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s13054-020-2777-y","volume":"24","author":"M Bertoni","year":"2020","unstructured":"Bertoni M, Spadaro S, Goligher EC. Monitoring patient respiratory effort during mechanical ventilation: lung and diaphragm-protective ventilation. Crit Care. 2020;24:106\u201314.","journal-title":"Crit Care."},{"issue":"7","key":"3357_CR14","first-page":"897","volume":"53","author":"AD Betensley","year":"2008","unstructured":"Betensley AD, Khalid I, Crawford J, Pensler RA, Digiovine B. Patient comfort during pressure support and volume controlled-continuous mandatory ventilation. Respir Care. 2008;53(7):897\u2013902.","journal-title":"Respir Care"},{"key":"3357_CR15","doi-asserted-by":"publisher","first-page":"61","DOI":"10.4187\/respcare.01077","volume":"56","author":"M de Wit","year":"2011","unstructured":"de Wit M. Monitoring of patient-ventilator interaction at the bedside Marjolein de Wit MD MSc. Respir Care. 2011;56:61\u201372.","journal-title":"Respir Care"},{"key":"3357_CR16","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1164\/ajrccm.161.3.9902065","volume":"161","author":"S Grasso","year":"2000","unstructured":"Grasso S, Puntillo F, Mascia L, Ancona G, Fiore T, Bruno F, et al. Compensation for increase in respiratory workload during mechanical ventilation: pressure-support versus proportional-assist ventilation. Am J Respir Crit Care Med. 2000;161:819\u201326.","journal-title":"Am J Respir Crit Care Med"},{"key":"3357_CR17","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1164\/ajrccm\/141.2.327","volume":"141","author":"NR Macintyre","year":"1990","unstructured":"Macintyre NR, Leatherman NE. Ventilatory muscle loads and the frequency-tidal volume pattern during inspiratory pressure-assisted (pressure-supported) ventilation. Am Rev Respir Dis. 1990;141:327\u201331.","journal-title":"Am Rev Respir Dis"},{"key":"3357_CR18","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s13613-019-0482-2","volume":"9","author":"T Stripoli","year":"2019","unstructured":"Stripoli T, Spadaro S, Di Mussi R, Volta CA, Trerotoli P, De Carlo F, et al. High-flow oxygen therapy in tracheostomized patients at high risk of weaning failure. Ann Intensive Care [Internet]. 2019;9:4.","journal-title":"Ann Intensive Care [Internet]"},{"key":"3357_CR19","doi-asserted-by":"publisher","first-page":"1433","DOI":"10.1038\/71012","volume":"5","author":"C Sinderby","year":"1999","unstructured":"Sinderby C, Navalesi P, Beck J, Skrobik Y, Comtois N, Friberg S, et al. Neural control of mechanical ventilation in respiratory failure. Nat Med. 1999;5:1433\u20136.","journal-title":"Nat Med"},{"key":"3357_CR20","doi-asserted-by":"publisher","first-page":"1434","DOI":"10.1152\/jappl.1996.81.3.1434","volume":"81","author":"J Beck","year":"1996","unstructured":"Beck J, Sinderby C, Lindstr\u00f6m L, Grassino A. Influence of bipolar esophageal electrode positioning on measurements of human crural diaphragm electromyogram. J Appl Physiol. 1996;81:1434\u201349.","journal-title":"J Appl Physiol"},{"key":"3357_CR21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13054-018-2107-9","volume":"22","author":"R Di Mussi","year":"2018","unstructured":"Di Mussi R, Spadaro S, Stripoli T, Volta CA, Trerotoli P, Pierucci P, et al. High-flow nasal cannula oxygen therapy decreases postextubation neuroventilatory drive and work of breathing in patients with chronic obstructive pulmonary disease. Crit Care. 2018;22:1\u201311.","journal-title":"Crit Care"},{"key":"3357_CR22","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1152\/jappl.1998.85.3.1123","volume":"85","author":"J Beck","year":"1998","unstructured":"Beck J, Sinderby C, Lindstr\u00f6m L, Grassino A. Effects of lung volume on diaphragm EMG signal strength during voluntary contractions. J Appl Physiol. 1998;85:1123\u201334.","journal-title":"J Appl Physiol"},{"key":"3357_CR23","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1164\/rccm.201206-1117CP","volume":"187","author":"J Doorduin","year":"2013","unstructured":"Doorduin J, Van Hees HWH, Van Der Hoeven JG, Heunks LMA. Monitoring of the respiratory muscles in the critically ill. Am J Respir Crit Care Med. 2013;187:20\u20137.","journal-title":"Am J Respir Crit Care Med"},{"key":"3357_CR24","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1007\/s00134-011-2209-1","volume":"37","author":"H Roz\u00e9","year":"2011","unstructured":"Roz\u00e9 H, Lafrikh A, Perrier V, Germain A, Dewitte A, Gomez F, et al. Daily titration of neurally adjusted ventilatory assist using the diaphragm electrical activity. Intensive Care Med. 2011;37:1087\u201394.","journal-title":"Intensive Care Med"},{"key":"3357_CR25","first-page":"1","volume":"9","author":"L Piquilloud","year":"2019","unstructured":"Piquilloud L, Beloncle F, Richard JCM, Mancebo J, Mercat A, Brochard L. Information conveyed by electrical diaphragmatic activity during unstressed, stressed and assisted spontaneous breathing: a physiological study. Ann Intensive Care [Internet]. 2019;9:1\u201314.","journal-title":"Ann Intensive Care [Internet]"},{"issue":"4","key":"3357_CR26","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1007\/s00134-020-05942-6","volume":"46","author":"E Spinelli","year":"2020","unstructured":"Spinelli E, Mauri T, Beitler JR, Pesenti A, Brodie D. Respiratory drive in the acute respiratory distress syndrome: pathophysiology, monitoring, and therapeutic interventions. Intensive Care Med [Internet]. 2020;46(4):606\u201318.","journal-title":"Intensive Care Med [Internet]"},{"key":"3357_CR27","first-page":"33","volume":"81","author":"S Spadaro","year":"2015","unstructured":"Spadaro S, Marangoni E, Ragazzi R, Mojoli F, Verri M, Longo L, et al. A methodological approach for determination of maximal inspiratory pressure in patients undergoing invasive mechanical ventilation. Minerva Anestesiol. 2015;81:33\u20138.","journal-title":"Minerva Anestesiol"},{"key":"3357_CR28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13054-017-1599-z","volume":"21","author":"F Beloncle","year":"2017","unstructured":"Beloncle F, Piquilloud L, Rittayamai N, Sinderby C, Roz\u00e9 H, Brochard L. A diaphragmatic electrical activity-based optimization strategy during pressure support ventilation improves synchronization but does not impact work of breathing. Crit Care. 2017;21:1\u20138.","journal-title":"Crit Care"},{"key":"3357_CR29","doi-asserted-by":"publisher","first-page":"R182","DOI":"10.1186\/cc12865","volume":"17","author":"J Barwing","year":"2013","unstructured":"Barwing J, Pedroni C, Olgem\u00f6ller U, Quintel M, Moerer O. Electrical activity of the diaphragm (EAdi) as a monitoring parameter in difficult weaning from respirator: a pilot study. Crit Care. 2013;17:R182.","journal-title":"Crit Care."},{"key":"3357_CR30","doi-asserted-by":"publisher","first-page":"1809","DOI":"10.1007\/s00134-009-1587-0","volume":"35","author":"J Barwing","year":"2009","unstructured":"Barwing J, Ambold M, Linden N, Quintel M, Moerer O. Evaluation of the catheter positioning for neurally adjusted ventilatory assist. Intensive Care Med. 2009;35:1809\u201314.","journal-title":"Intensive Care Med"},{"key":"3357_CR31","doi-asserted-by":"publisher","first-page":"1483","DOI":"10.1097\/CCM.0b013e31827caba0","volume":"41","author":"G Bellani","year":"2013","unstructured":"Bellani G, Mauri T, Coppadoro A, Grasselli G, Patroniti N, Spadaro S, et al. Estimation of patient\u2019s inspiratory effort from the electrical activity of the diaphragm. Crit Care Med. 2013;41:1483\u201391.","journal-title":"Crit Care Med"},{"key":"3357_CR32","first-page":"788","volume":"126","author":"A Baydur","year":"1982","unstructured":"Baydur A, Behrakis PK, Zin WA, Jaeger M, Milic-Emili J. A simple method for assessing the validity of the esophageal balloon technique. Am Rev Respir Dis. 1982;126:788\u201391.","journal-title":"Am Rev Respir Dis"},{"key":"3357_CR33","doi-asserted-by":"publisher","first-page":"1338","DOI":"10.1164\/rccm.2107138","volume":"166","author":"CN Sessler","year":"2002","unstructured":"Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O\u2019Neal PV, Keane KA, et al. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002;166:1338\u201344.","journal-title":"Am J Respir Crit Care Med"},{"key":"3357_CR34","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1097\/ALN.0b013e3181ee2ef1","volume":"113","author":"Y Coisel","year":"2010","unstructured":"Coisel Y, Chanques G, Jung B, Constantin JM, Capdevila X, Matecki S, et al. Neurally adjusted ventilatory assist in critically ill postoperative patients: a crossover randomized study. Anesthesiology. 2010;113:925\u201335.","journal-title":"Anesthesiology"},{"key":"3357_CR35","doi-asserted-by":"publisher","first-page":"1320","DOI":"10.1378\/chest.109.5.1320","volume":"109","author":"KI Berger","year":"1996","unstructured":"Berger KI, Sorkin IB, Norman RG, Rapoport DM, Goldring RM. Mechanism of relief of tachypnea during pressure support ventilation. Chest [Internet]. 1996a;109:1320\u20137.","journal-title":"Chest [Internet]"},{"key":"3357_CR36","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.1007\/s00134-006-0301-8","volume":"32","author":"AW Thille","year":"2006","unstructured":"Thille AW, Rodriguez P, Cabello B, Lellouche F, Brochard L. Patient-ventilator asynchrony during assisted mechanical ventilation. Intensive Care Med. 2006;32:1515\u201322.","journal-title":"Intensive Care Med"},{"key":"3357_CR37","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1093\/biomet\/73.1.13","volume":"73","author":"KY Liang","year":"1986","unstructured":"Liang KY, Zeger SL. Longitudinal data analysis using generalized linear models. Biometrika. 1986;73:13\u201322.","journal-title":"Biometrika"},{"key":"3357_CR38","volume-title":"Ventilatory failure","author":"M Younes","year":"1991","unstructured":"Younes M. Proportional assist ventilation and pressure support ventilation: similarities and differences. In: Marini JJ, Roussos C, editors. Ventilatory failure. Berlin: Springer; 1991."},{"key":"3357_CR39","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1164\/ajrccm\/145.1.114","volume":"145","author":"M Younes","year":"1992","unstructured":"Younes M. Proportional assist ventilation, a new approach to ventilatory support: theory. Am Rev Respir Dis. 1992;145:114\u201320.","journal-title":"Am Rev Respir Dis"},{"issue":"1","key":"3357_CR40","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1183\/09031936.97.10010177","volume":"10","author":"S Nava","year":"1997","unstructured":"Nava S, Bruschi C, Fracchia C, Braschi A, Rubini F. Patient-ventilator interaction and inspiratory effort during pressure support ventilation in patients with different pathologies. Eur Respir J. 1997;10(1):177\u201383.","journal-title":"Eur Respir J"},{"key":"3357_CR41","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1164\/ajrccm\/139.2.513","volume":"139","author":"L Brochard","year":"1989","unstructured":"Brochard L, Harf A, Lorino H, Lemaire F. Inspiratory pressure support prevents diaphragmatic fatigue during weaning from mechanical ventilation. Am Rev Respir Dis. 1989;139:513\u201321.","journal-title":"Am Rev Respir Dis"},{"issue":"20","key":"3357_CR42","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1186\/s13054-016-1479-y","volume":"28","author":"S Spadaro","year":"2016","unstructured":"Spadaro S, Grasso S, Mauri T, Dalla Corte F, Alvisi V, Ragazzi R, et al. Can diaphragmatic ultrasonography performed during the T-tube trial predict weaning failure? The role of diaphragmatic rapid shallow breathing index. Crit Care. 2016;28(20):305.","journal-title":"Crit Care"},{"key":"3357_CR43","doi-asserted-by":"publisher","first-page":"1320","DOI":"10.1378\/chest.109.5.1320","volume":"109","author":"KI Berger","year":"1996","unstructured":"Berger KI, Sorkin IB, Norman RG, Rapoport DM, Goldring RM. Mechanism of relief of tachypnea during pressure support ventilation. Chest. 1996b;109:1320\u20137.","journal-title":"Chest"},{"key":"3357_CR44","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2253-15-1","volume":"15","author":"H Yonis","year":"2015","unstructured":"Yonis H, Crognier L, Conil JM, Serres I, Rouget A, Virtos M, et al. Patient-ventilator synchrony in Neurally Adjusted Ventilatory Assist (NAVA) and Pressure Support Ventilation (PSV): a prospective observational study. BMC Anesthesiol [Internet]. 2015;15:1\u20139.","journal-title":"BMC Anesthesiol [Internet]"},{"key":"3357_CR45","doi-asserted-by":"publisher","first-page":"2010","DOI":"10.1007\/s00134-008-1208-3","volume":"34","author":"D Colombo","year":"2008","unstructured":"Colombo D, Cammarota G, Bergamaschi V, De Lucia M, Corte FD, Navalesi P. Physiologic response to varying levels of pressure support and neurally adjusted ventilatory assist in patients with acute respiratory failure. Intensive Care Med. 2008;34:2010\u20138.","journal-title":"Intensive Care Med."},{"key":"3357_CR46","first-page":"1110","volume":"56","author":"M Younes","year":"1984","unstructured":"Younes M, Riddle W. Relation between respiratory neural output and tidal volume. J Appl Physiol Respir Environ Exerc Physiol. 1984;56:1110\u20139.","journal-title":"J Appl Physiol Respir Environ Exerc Physiol"},{"key":"3357_CR47","doi-asserted-by":"publisher","first-page":"59S","DOI":"10.1378\/chest.97.3_Supplement.59S","volume":"97","author":"M Younes","year":"1990","unstructured":"Younes M. Load responses, dyspnea, and respiratory failure. Chest. 1990;97:59S-68S.","journal-title":"Chest"},{"key":"3357_CR48","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1007\/s00134-013-2850-y","volume":"39","author":"C Alexopoulou","year":"2013","unstructured":"Alexopoulou C, Kondili E, Plataki M, Georgopoulos D. Patient-ventilator synchrony and sleep quality with proportional assist and pressure support ventilation. Intensive Care Med. 2013;39:1040\u20137.","journal-title":"Intensive Care Med"},{"key":"3357_CR49","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1378\/chest.117.3.809","volume":"117","author":"AB Cooper","year":"2000","unstructured":"Cooper AB, Thornley KS, Young GB, Slutsky AS, Stewart TE, Hanly PJ. Sleep in critically ill patients requiring mechanical ventilation. Chest. 2000;117:809\u201318.","journal-title":"Chest"},{"issue":"2","key":"3357_CR50","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1007\/s00134-003-2030-6","volume":"30","author":"S Parthasarathy","year":"2004","unstructured":"Parthasarathy S, Tobin MJ. Sleep in the intensive care unit. Intensive Care Med. 2004;30(2):197\u2013206.","journal-title":"Intensive Care Med"},{"issue":"1","key":"3357_CR51","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1152\/jappl.1996.81.1.426","volume":"81","author":"VM Ranieri","year":"1996","unstructured":"Ranieri VM, Giuliani R, Mascia L, Grasso S, Petruzzelli V, Puntillo N, et al. Patient-ventilator interaction during acute hypercapnia: pressure-support vs. proportional-assist ventilation. J Appl Physiol. 1996;81(1):426\u201336.","journal-title":"J Appl Physiol"},{"issue":"3","key":"3357_CR52","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1186\/cc11297","volume":"16","author":"N Terzi","year":"2012","unstructured":"Terzi N, Piquilloud L, Roz\u00e9 H, Mercat A, Lofaso F, Delisle S, et al. Clinical review: update on neurally adjusted ventilatory assist\u2013report of a round-table conference. Crit Care. 2012;16(3):225.","journal-title":"Crit Care"},{"key":"3357_CR53","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1164\/ajrccm\/145.1.121","volume":"145","author":"M Younes","year":"1992","unstructured":"Younes M, Puddy A, Roberts D, Light RB, Quesada A, Taylor K, et al. Proportional assist ventilation: results of an initial clinical trial. Am Rev Respir Dis. 1992;145:121\u20139.","journal-title":"Am Rev Respir Dis"},{"key":"3357_CR54","doi-asserted-by":"publisher","first-page":"1371","DOI":"10.1007\/s00134-010-1917-2","volume":"36","author":"GA Iotti","year":"2010","unstructured":"Iotti GA, Polito A, Belliato M, Pasero D, Beduneau G, Wysocki M, et al. Adaptive support ventilation versus conventional ventilation for total ventilatory support in acute respiratory failure. Intensive Care Med. 2010;36:1371\u20139.","journal-title":"Intensive Care Med"},{"key":"3357_CR55","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1007\/s00134-007-0847-0","volume":"34","author":"JM Arnal","year":"2008","unstructured":"Arnal JM, Wysocki M, Nafati C, Donati S, Granier I, Corno G, et al. Automatic selection of breathing pattern using adaptive support ventilation. Intensive Care Med. 2008;34:75\u201381.","journal-title":"Intensive Care Med"},{"issue":"16","key":"3357_CR56","doi-asserted-by":"publisher","first-page":"382","DOI":"10.21037\/atm.2019.07.60","volume":"17","author":"C Chen","year":"2019","unstructured":"Chen C, Wen T, Liao W. Neurally adjusted ventilatory assist versus pressure support ventilation in patient-ventilator interaction and clinical outcomes: a meta-analysis of clinical trials. Ann Transl Med. 2019;17(16):382.","journal-title":"Ann Transl Med"},{"key":"3357_CR57","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.1056\/NEJMoa070447","volume":"358","author":"S Levine","year":"2008","unstructured":"Levine S, Nguyen T, Taylor N, Friscia ME, Budak MT, Rothenberg P, et al. Rapid disuse atrophy of diaphragm fibers in mechanically ventilated humans. N Engl J Med. 2008;358:1327\u201335.","journal-title":"N Engl J Med"},{"key":"3357_CR58","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1007\/s00134-015-3692-6","volume":"41","author":"L Blanch","year":"2015","unstructured":"Blanch L, Villagra A, Sales B, Montanya J, Lucangelo U, Luj\u00e1n M, et al. Asynchronies during mechanical ventilation are associated with mortality. Intensive Care Med. 2015;41:633\u201341.","journal-title":"Intensive Care Med"},{"issue":"1","key":"3357_CR59","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/MCC.0b013e328334b166","volume":"16","author":"BJ Petrof","year":"2010","unstructured":"Petrof BJ, Jaber S, Matecki S. Ventilator-induced diaphragmatic dysfunction. Curr Opin Crit Care. 2010;16(1):19\u201325.","journal-title":"Curr Opin Crit Care"},{"issue":"9","key":"3357_CR60","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1164\/rccm.201503-0620OC","volume":"192","author":"EC Goligher","year":"2015","unstructured":"Goligher EC, Fan E, Herridge MS, Murray A, Vorona S, Brace D, et al. Evolution of diaphragm thickness during mechanical ventilation: Impact of inspiratory effort. Am J Respir Crit Care Med. 2015;192(9):1080\u20138.","journal-title":"Am J Respir Crit Care Med"},{"key":"3357_CR61","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1164\/rccm.201604-0748CP","volume":"195","author":"T Yoshida","year":"2017","unstructured":"Yoshida T, Fujino Y, Amato MBP, Kavanagh BP. Fifty years of research in ards spontaneous breathing during mechanical ventilation risks, mechanisms, and management. Am J Respir Crit Care Med. 2017;195:985\u201392.","journal-title":"Am J Respir Crit Care Med"},{"issue":"21","key":"3357_CR62","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1186\/s13054-017-1702-5","volume":"26","author":"G Mortamet","year":"2017","unstructured":"Mortamet G, Proulx F, Crulli B, Savy N, Jouvet P, Emeriaud G. Diaphragm electrical activity monitoring as a breakpoint in the management of a tetraplegic child. Crit Care. 2017;26(21):116.","journal-title":"Crit Care"},{"issue":"7","key":"3357_CR63","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1164\/rccm.202003-0655CP","volume":"202","author":"EC Goligher","year":"2020","unstructured":"Goligher EC, Dres M, Patel BK, Sahetya SK, Beitler JR, Telias I, et al. Lung and diaphragm-protective ventilation. J Respir Crit Care Med. 2020;202(7):950\u201361.","journal-title":"J Respir Crit Care Med."},{"issue":"16","key":"3357_CR64","doi-asserted-by":"publisher","first-page":"R143","DOI":"10.1186\/cc11451","volume":"31","author":"L Liu","year":"2012","unstructured":"Liu L, Liu H, Yang Y, Huang Y, Liu S, Beck J, et al. Neuroventilatory efficiency and extubation readiness in critically ill patients. Crit Care. 2012;31(16):R143.","journal-title":"Crit Care"},{"key":"3357_CR65","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1164\/ajrccm\/143.3.469","volume":"143","author":"CSH Sassoon","year":"1991","unstructured":"Sassoon CSH, Light RW, Lodia R, Sieck GC, Mahutte CK. Pressure-time product during continuous positive airway pressure, pressure support ventilation, and T-piece during weaning from mechanical ventilation. Am Rev Respir Dis. 1991;143:469\u201375.","journal-title":"Am Rev Respir Dis"},{"key":"3357_CR66","doi-asserted-by":"publisher","first-page":"e678","DOI":"10.1097\/CCM.0000000000001649","volume":"44","author":"T Yoshida","year":"2016","unstructured":"Yoshida T, Roldan R, Beraldo MA, Torsani V, Gomes S, De Santis RR, et al. Spontaneous effort during mechanical ventilation: maximal injury with less positive end-expiratory pressure. Crit Care Med. 2016;44:e678\u201388.","journal-title":"Crit Care Med"},{"issue":"4","key":"3357_CR67","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1164\/rccm.201709-1917OC","volume":"198","author":"J Lindqvist","year":"2018","unstructured":"Lindqvist J, Van Den Berg M, Van Der Pijl R, Hooijman PE, Beishuizen A, Elshof J, et al. Positive end-expiratory pressure ventilation induces longitudinal atrophy in diaphragm fibers. Am J Respir Crit Care Med. 2018;198(4):472\u201385.","journal-title":"Am J Respir Crit Care Med"},{"key":"3357_CR68","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1007\/s00134-016-4400-x","volume":"42","author":"T Mauri","year":"2016","unstructured":"Mauri T, Yoshida T, Bellani G, Goligher EC, Carteaux G, Rittayamai N, et al. Esophageal and transpulmonary pressure in the clinical setting: meaning, usefulness and perspectives. Intensive Care Med. 2016;42:1360\u201373.","journal-title":"Intensive Care Med"}],"container-title":["Critical Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13054-020-03357-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s13054-020-03357-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13054-020-03357-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T17:51:45Z","timestamp":1697133105000},"score":1,"resource":{"primary":{"URL":"https:\/\/ccforum.biomedcentral.com\/articles\/10.1186\/s13054-020-03357-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,20]]},"references-count":68,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["3357"],"URL":"https:\/\/doi.org\/10.1186\/s13054-020-03357-9","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-52434\/v1","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-52434\/v2","asserted-by":"object"}]},"ISSN":["1364-8535"],"issn-type":[{"value":"1364-8535","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,20]]},"assertion":[{"value":"13 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 October 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 November 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved both by the ethics committee of the Azienda Ospedaliero-Universitaria Policlinico di Bari (protocol no. 257) and by the ethics committee of the Arcispedale Sant\u2019Anna hospital, Ferrara, Italy (protocol no. 131084). All patient enrolled in this study or their next of kin signed an informed consent. The study was conducted in accordance with the Declaration of Helsinki.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Available.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Salvatore Grasso in the past 2\u00a0years received fees for lectures and board membership from: Getinge Critical Care (Solna SW), Estor Critical Care (Pero, Milan Italy). The other authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"652"}}