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Neural versus pneumatic control of pressure support in patients with chronic obstructive pulmonary diseases at different levels of positive end expiratory pressure: a physiological study

Overview of attention for article published in Critical Care, December 2015
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (57th percentile)

Mentioned by

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5 tweeters
facebook
2 Facebook pages

Citations

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18 Dimensions

Readers on

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59 Mendeley
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Title
Neural versus pneumatic control of pressure support in patients with chronic obstructive pulmonary diseases at different levels of positive end expiratory pressure: a physiological study
Published in
Critical Care, December 2015
DOI 10.1186/s13054-015-0971-0
Pubmed ID
Authors

Ling Liu, Feiping Xia, Yi Yang, Federico Longhini, Paolo Navalesi, Jennifer Beck, Christer Sinderby, Haibo Qiu

Abstract

Intrinsic positive end-expiratory pressure (PEEPi) is a "threshold" load that must be overcome to trigger conventional pneumatically-controlled pressure support (PSP) in chronic obstructive pulmonary disease (COPD). Application of extrinsic PEEP (PEEPe) reduces trigger delays and mechanical inspiratory efforts. Using the diaphragm electrical activity (EAdi), neurally controlled pressure support (PSN) could hypothetically eliminate asynchrony and reduce mechanical inspiratory effort, hence substituting the need for PEEPe. The primary objective of this study was to show that PSN can reduce the need for PEEPe to improve patient-ventilator interaction and to reduce both the "pre-trigger" and "total inspiratory" neural and mechanical efforts in COPD patients with PEEPi. A secondary objective was to evaluate the impact of applying PSN on breathing pattern. Twelve intubated and mechanically ventilated COPD patients with PEEPi ≥ 5 cm H2O underwent comparisons of PSP and PSN at different levels of PEEPe (at 0 %, 40 %, 80 %, and 120 % of static PEEPi, for 12 minutes at each level on average), at matching peak airway pressure. We measured flow, airway pressure, esophageal pressure, and EAdi, and analyzed neural and mechanical efforts for triggering and total inspiration. Patient-ventilator interaction was analyzed with the NeuroSync index. Mean airway pressure and PEEPe were comparable for PSP and PSN at same target levels. During PSP, the NeuroSync index was 29 % at zero PEEPe and improved to 21 % at optimal PEEPe (P < 0.05). During PSN, the NeuroSync index was lower (<7 %, P < 0.05) regardless of PEEPe. Both pre-trigger (P < 0.05) and total inspiratory mechanical efforts (P < 0.05) were consistently higher during PSP compared to PSN at same PEEPe. The change in total mechanical efforts between PSP at PEEPe0% and PSN at PEEPe0% was not different from the change between PSP at PEEPe0% and PSP at PEEPe80%. PSN abolishes the need for PEEPe in COPD patients, improves patient-ventilator interaction, and reduces the inspiratory mechanical effort to breathe. Clinicaltrials.gov NCT02114567 . Registered 04 November 2013.

Twitter Demographics

The data shown below were collected from the profiles of 5 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 59 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Spain 1 2%
Unknown 58 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 12 20%
Other 7 12%
Researcher 6 10%
Student > Bachelor 5 8%
Student > Postgraduate 5 8%
Other 11 19%
Unknown 13 22%
Readers by discipline Count As %
Medicine and Dentistry 24 41%
Nursing and Health Professions 7 12%
Computer Science 3 5%
Psychology 2 3%
Engineering 2 3%
Other 5 8%
Unknown 16 27%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 November 2015.
All research outputs
#10,639,450
of 19,240,244 outputs
Outputs from Critical Care
#3,913
of 5,569 outputs
Outputs of similar age
#102,477
of 245,910 outputs
Outputs of similar age from Critical Care
#2
of 3 outputs
Altmetric has tracked 19,240,244 research outputs across all sources so far. This one is in the 44th percentile – i.e., 44% of other outputs scored the same or lower than it.
So far Altmetric has tracked 5,569 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 17.4. This one is in the 28th percentile – i.e., 28% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 245,910 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 57% of its contemporaries.
We're also able to compare this research output to 3 others from the same source and published within six weeks on either side of this one.