{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T22:44:18Z","timestamp":1785797058703,"version":"3.56.0"},"reference-count":21,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T00:00:00Z","timestamp":1679356800000},"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":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Patient-triggered adaptive pressure control (APC) continuous mandatory ventilation (CMV) (APC-CMV) has been widely adopted as an alternative ventilator mode to patient-triggered volume control (VC) CMV (VC-CMV). However, the comparative effectiveness of the 2 ventilator modes remains uncertain. We sought to explore clinical and implementation factors pertinent to a future definitive randomized controlled trial assessing APC-CMV versus VC-CMV as an initial ventilator mode strategy. The research objectives in our pilot trial tested clinician adherence and explored clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>In a single-center pragmatic sequential cluster crossover pilot trial, we enrolled all eligible adults with acute respiratory failure requiring mechanical ventilation admitted during a 9-week period to the medical ICU. Two-week time epochs were assigned a priori in which subjects received either APC-CMV or VC-CMV The primary outcome of the trial was feasibility, defined as 80% of subjects receiving the assigned mode within 1 h of initiation of ICU ventilation. The secondary outcome was proportion of the first 24 h on the assigned mode. Finally, we surveyed clinician stakeholders to understand potential facilitators and barriers to conducting a definitive randomized trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      We enrolled 137 subjects who received 152 discreet episodes of mechanical ventilation during time epochs assigned to APC-CMV (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 61) and VC-CMV (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 91). One hundred and thirty-one episodes were included in the prespecified primary outcome. One hundred and twenty-six (96%) received the assigned mode within the first hour of ICU admission (60 of 61 subjects assigned APC-CMV and 66 of 70 assigned VC-CMV). VC-CMV subjects spent a lower proportion of first 24 h (84% [95% CI 78\u201389]) on the assigned mode than APC-CMV recipients (95% [95% CI 91\u2013100]). Mixed-methods analyses identified preconceived perceptions of subject comfort by clinicians and need for real-time education to address this concern.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In this pilot pragmatic, sequential crossover trial, unit-wide allocation to a ventilator mode was feasible and acceptable to clinicians.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.10803","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T11:20:33Z","timestamp":1679397633000},"page":"1331-1339","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["A Pragmatic Pilot Trial Comparing Patient-Triggered Adaptive Pressure Control to Patient-Triggered Volume Control Ventilation in Critically Ill Adults"],"prefix":"10.1177","volume":"68","author":[{"given":"Kevin W","family":"Gibbs","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy, and Immunology, Wake Forest School of Medicine, Winston-Salem, North Carolina; and Critical Illness Injury and Recovery Research Center, Wake Forest School of Medicine, Winston-Salem, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan L","family":"Forbes","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy, and Immunology, Wake Forest School of Medicine, Winston-Salem, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey J","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Respiratory Care, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer TW","family":"Krall","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy, and Immunology, Wake Forest School of Medicine, Winston-Salem, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aubrae A","family":"Isenhart","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy, and Immunology, Wake Forest School of Medicine, Winston-Salem, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie P","family":"Taylor","sequence":"additional","affiliation":[{"name":"Critical Illness Injury and Recovery Research Center, Wake Forest School of Medicine, Winston-Salem, North Carolina; and Department of Internal Medicine, Wake Forest School of Medicine, Charlotte, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R Shayn","family":"Martin","sequence":"additional","affiliation":[{"name":"Critical Illness Injury and Recovery Research Center, Wake Forest School of Medicine, Winston-Salem, North Carolina; and Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel S","family":"O'Connell","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita N","family":"Bakhru","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy, and Immunology, Wake Forest School of Medicine, Winston-Salem, North Carolina; and Critical Illness Injury and Recovery Research Center, Wake Forest School of Medicine, Winston-Salem, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica A","family":"Palakshappa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy, and Immunology, Wake Forest School of Medicine, Winston-Salem, North Carolina; and Critical Illness Injury and Recovery Research Center, Wake Forest School of Medicine, Winston-Salem, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D Clark","family":"Files","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy, and Immunology, Wake Forest School of Medicine, Winston-Salem, North Carolina; and Critical Illness Injury and Recovery Research Center, Wake Forest School of Medicine, Winston-Salem, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,3,21]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-018-3534-z"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201212-2169OC"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.09541467"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.07520478"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-019-2698-9"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201605-362OC"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202203-200RL"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc107"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000000485"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.4338\/ACI-2012-06-RA-0026"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"issue":"23","key":"e_1_3_2_13_2","first-page":"2526","article-title":"Acute respiratory distress syndrome: the Berlin definition","volume":"307","author":"Ranieri VM","year":"2012","unstructured":"Ranieri VM, , Rubenfeld GD, , Thompson BT, , Ferguson ND, , Caldwell E, et al. on behalf of the Acute Respiratory Distress Taskforce. Acute respiratory distress syndrome: the Berlin definition. JAMA, 2012; 307(23):2526\u20132533.","journal-title":"JAMA"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003071"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01709751"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201810-2050CP"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201409-1598OC"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.14280"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200005043421801"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201807-459OC"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05501623"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-016-4423-3"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.4187\/respcare.10803","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.10803","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.10803","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T11:09:09Z","timestamp":1775473749000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.4187\/respcare.10803"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,21]]},"references-count":21,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.4187\/respcare.10803"],"URL":"https:\/\/doi.org\/10.4187\/respcare.10803","relation":{},"ISSN":["0020-1324"],"issn-type":[{"value":"0020-1324","type":"print"}],"subject":[],"published":{"date-parts":[[2023,3,21]]}}}