{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T22:53:24Z","timestamp":1775516004478,"version":"3.50.1"},"reference-count":30,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"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":["Respir Care"],"published-print":{"date-parts":[[2019,8]]},"abstract":"\n BACKGROUND:<\/jats:title>\n \n Low tidal volume (V\n T<\/jats:sub>\n ) ventilation has become the preferred approach in patients in the ICU. Sedation reduces V\n T<\/jats:sub>\n by attenuating respiratory drive. Even in deep sedation, some patients exhibit high V\n T<\/jats:sub>\n . We aimed to determine factors associated with low V\n T<\/jats:sub>\n ventilation in deeply sedated subjects who exhibited an inspiratory effort by examination of the acid\/base balance using the Stewart model.\n <\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n \n The medical records of 630 consecutive subjects admitted to the ICU over 1 y were reviewed retrospectively, and daily data sets of patients with a persistent inspiratory effort, P\n \n aO\n 2<\/jats:sub>\n <\/jats:sub>\n \/F\n \n IO\n 2<\/jats:sub>\n <\/jats:sub>\n < 300 mm Hg, PEEP > 5 cm H\n 2<\/jats:sub>\n O, and a Richmond Agitation Sedation Scale score of \u22124 or \u22125 who received assisted pressure-regulated ventilation were collected. The data sets were stratified into high V\n T<\/jats:sub>\n (\u2265 8 mL\/kg predicted body weight [PBW]) and low V\n T<\/jats:sub>\n (> 8 mL\/kg PBW) groups.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n Among 235 matched data sets from 100 subjects, 101 and 134 data sets were in the low V\n T<\/jats:sub>\n and high V\n T<\/jats:sub>\n groups, respectively. Set pressure was not different between the groups. PEEP was lower in the low V\n T<\/jats:sub>\n group, and opioids were more frequently used in the high V\n T<\/jats:sub>\n group. Strong ion difference (SID) was higher in the low V\n T<\/jats:sub>\n group. Multivariate analysis revealed that higher SID, lower total nonvolatile weak anion (A\n TOT<\/jats:sub>\n ), and absence of opioid administration were associated with attaining low V\n T<\/jats:sub>\n ventilation. Furthermore, V\n T<\/jats:sub>\n \/PBW and SID demonstrated a weak inverse correlation, whereas V\n T<\/jats:sub>\n \/PBW and A\n TOT<\/jats:sub>\n exhibited a weak correlation. V\n T<\/jats:sub>\n \/PBW was lower in the group with higher SID and lower A\n TOT<\/jats:sub>\n , indicating a tendency of metabolic alkalosis.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n \n Despite weak effects of high SID and low A\n TOT<\/jats:sub>\n , efficient management of the buffering function might be a feasible strategy to achieve low V\n T<\/jats:sub>\n ventilation.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4187\/respcare.06197","type":"journal-article","created":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T15:45:27Z","timestamp":1556639127000},"page":"890-898","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Attaining Low Tidal Volume Ventilation During Patient Triggered Ventilation in Sedated Subjects"],"prefix":"10.1177","volume":"64","author":[{"given":"Moe","family":"Koide","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akinori","family":"Uchiyama","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomonori","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuji","family":"Fujino","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,8,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201409-1598OC"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200005043421801"},{"key":"e_1_3_2_4_2","first-page":"CD003844","article-title":"Lung protective ventilation strategy for the acute respiratory distress syndrome","volume":"2","author":"Petrucci N","year":"2013","unstructured":"Petrucci N, , De Feo C. Lung protective ventilation strategy for the acute respiratory distress syndrome. Cochrane Database Syst Rev, 2013; 2:CD003844.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-015-0091-6"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1301082"},{"key":"e_1_3_2_7_2","first-page":"CD011151","article-title":"Intraoperative use of low volume ventilation to decrease postoperative mortality, mechanical ventilation, lengths of stay and lung injury in patients without acute lung injury","volume":"12","author":"Guay J","year":"2015","unstructured":"Guay J, , Ochroch EA. Intraoperative use of low volume ventilation to decrease postoperative mortality, mechanical ventilation, lengths of stay and lung injury in patients without acute lung injury. Cochrane Database Syst Rev, 2015; 12:CD011151.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31829102de"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.13730"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-3169"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199710000-00016"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2006.12.003"},{"issue":"11","key":"e_1_3_2_13_2","first-page":"1158","article-title":"Factors associated with adherence to low-tidal volume strategy for acute lung injury and acute respiratory distress syndrome and their impacts on outcomes: an observational study and propensity analysis","volume":"80","author":"Chen YF","year":"2014","unstructured":"Chen YF, , Lim CK, , Ruan SY, , Jerng JS, , Lin JW, , Kuo PH, et al. Factors associated with adherence to low-tidal volume strategy for acute lung injury and acute respiratory distress syndrome and their impacts on outcomes: an observational study and propensity analysis. Minerva Anestesiol, 2014; 80(11):1158\u20131168.","journal-title":"Minerva Anestesiol"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001710"},{"issue":"8","key":"e_1_3_2_15_2","first-page":"519","article-title":"Clinical practice guidelines for evidence-based management of sedoanalgesia in critically ill adult patients","volume":"37","author":"Celis-Rodr\u00edguez E","year":"2013","unstructured":"Celis-Rodr\u00edguez E, , Birchenall C, , de la Cal M\u00c1, , Castorena Arellano G, , Hern\u00e1ndez A, , Ceraso D, et al. Clinical practice guidelines for evidence-based management of sedoanalgesia in critically ill adult patients. Med Intensiva, 2013; 37(8):519\u2013574.","journal-title":"Med Intensiva"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31816fc3d0"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1215672"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.5492\/wjccm.v4.i1.62"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001261"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/0034-5687(93)90085-O"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.162.6.9904099"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000259536.11943.90"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-009-1496-2"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000125517.28517.74"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1998.84.5.1740"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2006.15.4.420"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1139\/y83-207"},{"key":"e_1_3_2_28_2","first-page":"61","article-title":"Nunn's applied respiratory physiology, 7th edition","author":"Lumb AB","year":"2010","unstructured":"Lumb AB, , Pearl RG. Nunn's applied respiratory physiology, 7th edition. London: Churchill Livingstone Elsevier, 2010; 61\u201382.","journal-title":"London: Churchill Livingstone Elsevier"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000504"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc7105"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0291"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.4187\/respcare.06197","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.06197","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.06197","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T11:08:57Z","timestamp":1775473737000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.4187\/respcare.06197"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8]]},"references-count":30,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.4187\/respcare.06197"],"URL":"https:\/\/doi.org\/10.4187\/respcare.06197","relation":{},"ISSN":["0020-1324"],"issn-type":[{"value":"0020-1324","type":"print"}],"subject":[],"published":{"date-parts":[[2019,8]]}}}