{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T03:07:10Z","timestamp":1788923230596,"version":"build-2803163510"},"reference-count":27,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2022,11,11]],"date-time":"2022-11-11T00:00:00Z","timestamp":1668124800000},"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":[[2023,5]]},"abstract":"\n BACKGROUND:<\/jats:title>\n The Oxylator is an automatic resuscitator, powered only by an oxygen cylinder with no electricity required, that could be used in acute respiratory failure in situations in which standard mechanical ventilation is not available or feasible. We aimed to assess the feasibility and safety of mechanical ventilation by using this automatic resuscitator in an animal model of ARDS.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n \n A randomized experimental study in a porcine ARDS model with 12 pigs randomized to the Oxylator group or the control group (6 per group) and ventilated for 4 h. In the Oxylator group, peak pressure was set at 20 cm H\n 2<\/jats:sub>\n O and PEEP was set at the lowest observed breathing frequency during a decremental PEEP titration. The control pigs were ventilated with a conventional ventilator by using protective settings and PEEP at the crossing point of collapse and overdistention, as indicated by electrical impedance tomography. Our end points were feasibility and safety as well as respiratory mechanics, gas exchange, and hemodynamics.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n After lung injury, the mean \u00b1 SD respiratory system compliance and P\n \n aO\n 2<\/jats:sub>\n <\/jats:sub>\n \/F\n \n IO\n 2<\/jats:sub>\n <\/jats:sub>\n were 13 \u00b1 2 mL\/cm H\n 2<\/jats:sub>\n O and 61 \u00b1 17 mm Hg, respectively. The mean \u00b1 SD total PEEP was 10 \u00b1 2 cm H\n 2<\/jats:sub>\n O and 13 \u00b1 2 cm H\n 2<\/jats:sub>\n O in the control and Oxylator groups, respectively (\n P<\/jats:italic>\n = .046). The mean plateau pressure was kept to < 30 cm H\n 2<\/jats:sub>\n O in both groups. In the Oxylator group, the tidal volume was transiently > 8 mL\/kg but was 6 \u00b1 0.4 mL\/kg at 4 h, whereas the breathing frequency increased from 38 \u00b1 4 to 48 \u00b1 3 breaths\/min (\n P<\/jats:italic>\n < .001). There was no difference in driving pressure, compliance, P\n \n aO\n 2<\/jats:sub>\n <\/jats:sub>\n \/F\n \n IO\n 2<\/jats:sub>\n <\/jats:sub>\n , and pulmonary shunt between the groups. The mean \u00b1 SD P\n \n aCO\n 2<\/jats:sub>\n <\/jats:sub>\n was higher in the Oxylator group after 4 h, 74 \u00b1 9 mm Hg versus 58 \u00b1 6 mm Hg (\n P<\/jats:italic>\n < .001). There were no differences in hemodynamics between the groups, including blood pressure and cardiac output.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Short-term mechanical ventilation by using an automatic resuscitator and a fixed pressure setting in an ARDS animal model was feasible and safe.<\/jats:p>\n <\/jats:sec>","DOI":"10.4187\/respcare.10389","type":"journal-article","created":{"date-parts":[[2022,11,11]],"date-time":"2022-11-11T12:00:26Z","timestamp":1668168026000},"page":"611-619","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Mechanical Ventilation in ARDS With an Automatic Resuscitator"],"prefix":"10.1177","volume":"68","author":[{"given":"Mayson LA","family":"Sousa","sequence":"first","affiliation":[{"name":"Keenan Centre for Biomedical Research, Critical Care Department, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada."},{"name":"Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada."},{"name":"Translational Medicine Program, Research Institute, Hospital for Sick Children. University of Toronto, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhushan H","family":"Katira","sequence":"additional","affiliation":[{"name":"Translational Medicine Program, Research Institute, Hospital for Sick Children. University of Toronto, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doreen","family":"Engelberts","sequence":"additional","affiliation":[{"name":"Translational Medicine Program, Research Institute, Hospital for Sick Children. University of Toronto, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Hsing","sequence":"additional","affiliation":[{"name":"Translational Medicine Program, Research Institute, Hospital for Sick Children. University of Toronto, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annia","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Keenan Centre for Biomedical Research, Critical Care Department, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada."},{"name":"Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemijn H","family":"Jonkman","sequence":"additional","affiliation":[{"name":"Keenan Centre for Biomedical Research, Critical Care Department, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada."},{"name":"Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Post","sequence":"additional","affiliation":[{"name":"Translational Medicine Program, Research Institute, Hospital for Sick Children. University of Toronto, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Dorian","sequence":"additional","affiliation":[{"name":"Keenan Centre for Biomedical Research, Division of Cardiology, St Michael's Hospital, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent J","family":"Brochard","sequence":"additional","affiliation":[{"name":"Keenan Centre for Biomedical Research, Critical Care Department, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada."},{"name":"Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada."},{"name":"Translational Medicine Program, Research Institute, Hospital for Sick Children. University of Toronto, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,11,11]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clim.2020.108509"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.12270"},{"issue":"23","key":"e_1_3_2_5_2","first-page":"2526","article-title":"Acute respiratory distress syndrome: the Berlin Definition","volume":"307","author":"Definition Task Force ARDS","year":"2012","unstructured":"Definition Task Force ARDS. Ranieri VM, , Rubenfeld GD, , Thompson BT, , Ferguson ND, , Caldwell E, et al. Acute respiratory distress syndrome: the Berlin Definition. 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