{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:06:12Z","timestamp":1787508372518,"version":"build-2736575974"},"reference-count":36,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T00:00:00Z","timestamp":1598313600000},"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":[[2021,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>\n                      The unifying goal of lung-protective ventilation strategies in ARDS is to minimize the strain and stress applied by mechanical ventilation to the lung to reduce ventilator-induced lung injury (VILI). The relative contributions of the magnitude and frequency of mechanical stress and the end-expiratory pressure to the development of VILI is unknown. Consequently, it is uncertain whether the risk of VILI is best quantified in terms of tidal volume (V\n                      <jats:sub>T<\/jats:sub>\n                      ), driving pressure (\u0394P), or mechanical power.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      The correlation between differences in V\n                      <jats:sub>T<\/jats:sub>\n                      , \u0394P, and mechanical power and the magnitude of mortality benefit in trials of lung-protective ventilation strategies in adult subjects with ARDS was assessed by meta-regression. Modified mechanical power was computed including PEEP (Power\n                      <jats:sub>elastic<\/jats:sub>\n                      ), excluding PEEP (Power\n                      <jats:sub>dynamic<\/jats:sub>\n                      ), and using \u0394P (Power\n                      <jats:sub>driving<\/jats:sub>\n                      ). The primary analysis incorporated all included trials. A secondary subgroup analysis was restricted to trials of lower versus higher PEEP strategies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      We included 9 trials involving 4,731 subjects in the analysis. Odds ratios for moderation derived from meta-regression showed that variations in V\n                      <jats:sub>T<\/jats:sub>\n                      , \u0394P, and Power\n                      <jats:sub>dynamic<\/jats:sub>\n                      were associated with increased mortality with odds ratios of 1.24 (95% CI 1.03\u20131.49), 1.31 (95% CI 1.03\u20131.66), and 1.37 (95% CI 1.05\u20131.78), respectively. In trials comparing higher versus lower PEEP strategies, Power\n                      <jats:sub>elastic<\/jats:sub>\n                      was increased in the higher PEEP arm (24 \u00b1 1.7 vs 20 \u00b1 1.5 J\/min, respectively), whereas the other parameters were not affected on average by a higher PEEP ventilation strategy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>\n                      In trials of lung-protective ventilation strategies, V\n                      <jats:sub>T<\/jats:sub>\n                      , \u0394P, Power\n                      <jats:sub>elastic<\/jats:sub>\n                      , Power\n                      <jats:sub>dynamic<\/jats:sub>\n                      , and Power\n                      <jats:sub>driving<\/jats:sub>\n                      exhibited similar moderation of treatment effect on mortality. In this study, modified mechanical power did not add important information on the risk of death from VILI in comparison to V\n                      <jats:sub>T<\/jats:sub>\n                      or \u0394P.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.07876","type":"journal-article","created":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T17:15:17Z","timestamp":1598375717000},"page":"221-227","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":50,"title":["Comparing the Effects of Tidal Volume, Driving Pressure, and Mechanical Power on Mortality in Trials of Lung-Protective Mechanical Ventilation"],"prefix":"10.1177","volume":"66","author":[{"given":"Jose","family":"Dianti","sequence":"first","affiliation":[{"name":"Interdepartmenal Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada."},{"name":"Department of Medicine, Division of Respirology, University Health Network, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Matelski","sequence":"additional","affiliation":[{"name":"Biostatistics Research Unit, University Health Network, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Tisminetzky","sequence":"additional","affiliation":[{"name":"Interdepartmenal Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada."},{"name":"Department of Medicine, Division of Respirology, University Health Network, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan J","family":"Walkey","sequence":"additional","affiliation":[{"name":"Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laveena","family":"Munshi","sequence":"additional","affiliation":[{"name":"Interdepartmenal Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada."},{"name":"Department of Medicine, Division of Respirology, University Health Network, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Del Sorbo","sequence":"additional","affiliation":[{"name":"Interdepartmenal Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada."},{"name":"Department of Medicine, Division of Respirology, University Health Network, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eddy","family":"Fan","sequence":"additional","affiliation":[{"name":"Interdepartmenal Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada."},{"name":"Department of Medicine, Division of Respirology, University Health Network, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo LV","family":"Costa","sequence":"additional","affiliation":[{"name":"Research and Education Institute, Hospital S\u00edrio-Liban\u00eas, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol L","family":"Hodgson","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care-Research Centre, Monash University, Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Brochard","sequence":"additional","affiliation":[{"name":"Interdepartmenal Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada."},{"name":"Li Ka Shing Knowledge Institute, Keenan Research Centre, St Michael's Hospital, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewan C","family":"Goligher","sequence":"additional","affiliation":[{"name":"Interdepartmenal Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada."},{"name":"Department of Medicine, Division of Respirology, University Health Network, Toronto, Ontario, 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