{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:52:38Z","timestamp":1791453158001,"version":"4.3.3"},"reference-count":37,"publisher":"American Spinal Injury Association","issue":"4","funder":[{"name":"Center for Clinical and Translational Sciences KL2 funding","award":["NCATS KL2-TR-003168-02"],"award-info":[{"award-number":["NCATS KL2-TR-003168-02"]}],"id":[{"id":"https:\/\/ror.org\/03fefqk78","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Craig H. Nielsen Foundation","award":["P007806"],"award-info":[{"award-number":["P007806"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To assess feasibility of comparing moderate-low (8-10 mL\/kg predicted body weight [PBW]) tidal volume (mLVT) versus moderate-high (14-16 mL\/kg PBW) tidal volume (mHVT) strategies, and to generate exploratory data on respiratory outcomes and systemic inflammation in individuals with subacute cervical spinal cord injury (SCI) requiring mechanical ventilation (MV).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In a randomized comparative effectiveness pilot trial at 2 inpatient rehabilitation hospitals, adults (\u226518 years) with traumatic cervical SCI on MV were randomized to mLVT or mHVT. The primary outcome was feasibility (recruitment, adherence, retention). Secondary outcomes included pneumonia, other pulmonary complications, ventilator-free days (VFDs), and weaning success at discharge. Exploratory outcomes were changes in inflammatory markers (IL-6, IL-8, TNF-\u03b1, IL-1\u03b2). Bayesian regression models estimated relative risks (RR) and posterior probabilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Thirty participants (15 per group) were enrolled. Recruitment and retention rates were 76% and 100%. VT adherence was higher in mLVT (87% vs. 73%). Exploratory analyses suggested estimated risks of pneumonia and pulmonary complications in mLVT were RR 1.71 (95% credible interval [CrI] 0.64, 4.75; posterior probability = 0.86) and RR 1.57 (CrI 0.76, 3.33; posterior probability = 0.89), respectively. Median VFDs were greater in mLVT (12 vs. 7 days; posterior probability = 0.70). Weaning success was similar (73%). Trends in inflammatory markers favored mLVT, with greater reductions in IL-6, IL-8, and TNF-\u03b1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This trial supports the feasibility of comparing mLVT and mHVT strategies in subacute cervical SCI. Findings should be interpreted as hypothesis-generating and primarily serve to inform outcome selection and sample size calculations for a definitive trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.46292\/sci25-00090","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:23:11Z","timestamp":1791451391000},"page":"1-19","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility of Tidal Volume Strategies in Subacute Cervical Spinal Cord Injury: A Pilot Randomized Trial"],"prefix":"10.46292","volume":"32","author":[{"given":"Radha","family":"Korupolu","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center, Houston, Texas"},{"name":"TIRR Memorial Hermann Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Argyrios","family":"Stampas","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center, Houston, Texas"},{"name":"TIRR Memorial Hermann Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shrasti","family":"Lohiya","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center, Houston, Texas"},{"name":"TIRR Memorial Hermann Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac Hernandez","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center, Houston, Texas"},{"name":"TIRR Memorial Hermann Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, The University of Colorado Anschutz Medical Campus, Aurora, Colorado"},{"name":"Craig Hospital, Englewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Fran\u00e7oise J.","family":"Doursout","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine, McGovern Medical School, The University of Texas Health Science Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center, Houston, Texas"},{"name":"TIRR Memorial Hermann Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randi","family":"Thompson","sequence":"additional","affiliation":[{"name":"TIRR Memorial Hermann Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Gillespie","sequence":"additional","affiliation":[{"name":"Craig Hospital, Englewood, Colorado"},{"name":"Critical Care and Pulmonary Consultants, P.C."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Pedroza","sequence":"additional","affiliation":[{"name":"Center for Clinical Research and Evidence-Based Medicine, The University of Texas Health Science Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Fenton","sequence":"additional","affiliation":[{"name":"Craig Hospital, Englewood, Colorado"},{"name":"Critical Care and Pulmonary Consultants, P.C."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"issue":"4","key":"b1","series-title":"Breathe (Sheff).","first-page":"328","article-title":"Respiratory problems and management in people with spinal cord injury","volume":"12","author":"Berlowitz DJ","year":"2016","unstructured":"Berlowitz DJ, Wadsworth B, Ross J. 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