{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T06:06:04Z","timestamp":1784786764252,"version":"3.55.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>After lung transplantation, the ventilated parenchyma is the donor lung rather than the recipient's native lung. Normalizing tidal volume to donor-predicted body weight (dPBW) indexes delivered ventilation to estimated graft size.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective single-center cohort study to evaluate whether dPBW-normalized tidal volume at intensive care unit admission after transplantation (T0) was associated with time-matched peak pressure difference under clinician-selected ventilation. Peak pressure difference was defined as peak airway pressure minus positive end-expiratory pressure and served as a peak airway pressure-derived pressure-burden metric rather than standard driving pressure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 85 adult lung transplant recipients in the primary complete-case analysis, higher T0 dPBW-normalized tidal volume was associated with lower T0 peak pressure difference after enhanced adjustment (\u03b2 = \u22120.531, 95% CI \u22121.031 to \u22120.032;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0376). Secondary analyses of dynamic compliance showed an association with higher time-matched dynamic compliance. In contrast, dPBW-normalized tidal volume did not show significant associations with severe primary graft dysfunction, liberation from invasive mechanical ventilation within 28 days, or 30-day mortality after enhanced adjustment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These exploratory findings describe associations between dPBW-normalized tidal volume and early peak airway pressure-derived burden under clinician-selected ventilation, but they do not establish a physiologic effect or support changes in ventilatory management. Prospective validation with protocolized ventilation and plateau-pressure measurements is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1873272","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T05:39:04Z","timestamp":1784785144000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Donor-size-normalized tidal volume and early peak airway pressure-derived pressure burden after lung transplantation: an exploratory single-center cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Tao","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine","place":["Shanghai, China"]},{"name":"School of Medicine, Tongji University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weidong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shanghai Pulmonary Hospital, Tongji University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junrong","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine","place":["Shanghai, 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