{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:03:31Z","timestamp":1785301411095,"version":"3.55.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"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. Physiol."],"abstract":"<jats:p>Mechanical ventilation is a life-saving intervention in critically ill patients; however, the real-time integration of its key physiological determinants elastic load, resistive load, and obstructive components remains cognitively demanding at the bedside. Current monitoring approaches present these parameters in fragmented formats, which may limit rapid interpretation. The Respiratory Pyramid Interface (RPI) is a conceptual, hypothesis-generating framework that integrates the fundamental variables of respiratory mechanics flow (F), pressure (P), and volume (V) into a unified three-dimensional geometric model. Within this structure, resistive, elastic, and obstructive components are represented along the pyramid edges, while derived indices including mechanical power (MP), driving pressure (DP), static compliance (Cstat), the Pyramid Asymmetry Index (PAI), and a pressure-based surrogate of the expiratory time constant (\u03c4_est) are dynamically mapped. The framework was demonstrated across eleven simulated pathophysiological scenarios, each producing distinct geometric patterns corresponding to specific mechanical phenotypes. Importantly, RPI does not introduce new physiological variables but offers a structured visual integration of routinely available ventilator data, intended to support hypothesis generation, education, and pattern recognition rather than to provide direct treatment guidance. Limitations of the underlying single-compartment model including regional lung heterogeneity, pendelluft, spontaneous respiratory effort, and elevated neural respiratory drive are acknowledged. Prospective validation is required before the proposed indices can be considered for clinical decision support.<\/jats:p>","DOI":"10.3389\/fphys.2026.1846417","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:45:15Z","timestamp":1785300315000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Respiratory pyramid interface (RPI): a conceptual three-dimensional pyramid model for visualization of lung mechanics during mechanical ventilation"],"prefix":"10.3389","volume":"17","author":[{"given":"Serdar","family":"Efe","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Intensive Care, Bursa Uluda\u011f University Faculty of Medicine","place":["Bursa, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1007\/s00134-007-0847-0","article-title":"Automatic selection of breathing pattern using adaptive support ventilation","volume":"34","author":"Arnal","year":"2008","journal-title":"Intensive Care Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1321","DOI":"10.1007\/s00134-019-05636-8","article-title":"Calculation of mechanical power for pressure-controlled ventilation","volume":"45","author":"Becher","year":"2019","journal-title":"Intensive Care Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1007\/s00134-015-3692-6","article-title":"Asynchronies during mechanical ventilation are associated with mortality","volume":"41","author":"Blanch","year":"2015","journal-title":"Intensive Care Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e2261","DOI":"10.1097\/ccm.0000000000006816","article-title":"The association between patient-ventilator asynchrony and clinical outcomes in mechanically ventilated patients: a systematic review","volume":"53","author":"de Bie","year":"2025","journal-title":"Crit. 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