Individualized Driving Pressure-Guided PEEP Fails to Reduce Pulmonary Complications in Open Abdominal Surgery: Results from the DESIGNATION Trial
Posted inAnesthesiology General Surgery news

Individualized Driving Pressure-Guided PEEP Fails to Reduce Pulmonary Complications in Open Abdominal Surgery: Results from the DESIGNATION Trial

The DESIGNATION trial demonstrates that driving pressure-guided high PEEP with recruitment maneuvers does not reduce postoperative pulmonary complications compared to standard low PEEP in patients undergoing open abdominal surgery, while significantly increasing the risk of intraoperative hypotension and the need for vasoactive support.
The Paradox of Personalized PEEP: Why Driving Pressure-Guided Ventilation Failed to Improve Outcomes in Emergency Surgery
Posted inAnesthesiology Critical Care news

The Paradox of Personalized PEEP: Why Driving Pressure-Guided Ventilation Failed to Improve Outcomes in Emergency Surgery

This article evaluates the IMPROVE-2 trial and a recent meta-analysis on driving pressure-guided PEEP. Despite physiological improvements in lung compliance, individualized PEEP failed to reduce postoperative respiratory failure in emergency surgery, highlighting a disconnect between respiratory mechanics and clinical survival.
High-frequency Oscillatory Ventilation in Near‑Term and Term Infants: Inconclusive Benefit and Possible Increased Mortality — What the 2025 Cochrane Update Tells Clinicians
Posted innews Pediatrics Respiratory

High-frequency Oscillatory Ventilation in Near‑Term and Term Infants: Inconclusive Benefit and Possible Increased Mortality — What the 2025 Cochrane Update Tells Clinicians

A 2025 Cochrane update (3 RCTs, 368 infants) finds very low- to low-certainty evidence that HFOV neither clearly reduces treatment failure nor pulmonary air leak and may increase mortality versus conventional ventilation in term/near‑term infants with severe pulmonary dysfunction.
Effectiveness of Automated Closed-Loop Ventilation versus Protocolized Conventional Ventilation in Critically Ill Adults: A Comprehensive Evidence Review
Posted inClinical Updates Critical Care news Respiratory

Effectiveness of Automated Closed-Loop Ventilation versus Protocolized Conventional Ventilation in Critically Ill Adults: A Comprehensive Evidence Review

Automated closed-loop ventilation improves ventilation quality but does not increase ventilator-free days at day 28 compared to protocolized conventional ventilation in critically ill adults, with benefits in safety profiles and caregiver workload.
Both Too Little and Too Much Respiratory Drive and Effort Predict Worse Outcomes on Mechanical Ventilation: Insights from a Prospective Toronto Cohort
Posted inCritical Care news Respiratory

Both Too Little and Too Much Respiratory Drive and Effort Predict Worse Outcomes on Mechanical Ventilation: Insights from a Prospective Toronto Cohort

A prospective registry study found a U-shaped relationship between respiratory drive/effort and ICU outcomes: both low and high drive/effort linked with higher mortality and slower discharge, especially when oxygenation (PaO2:FiO2) ≤150 mmHg; ventilator driving pressure effects were amplified by patient effort.
Persistent Inspiratory Muscle Weakness After Prolonged Intubation: MIP at Day 12 Predicts Failure to Recover in the Acute-Care Stay
Posted inCritical Care news Nursing & care Respiratory

Persistent Inspiratory Muscle Weakness After Prolonged Intubation: MIP at Day 12 Predicts Failure to Recover in the Acute-Care Stay

In patients extubated after ≥7 days of mechanical ventilation, 43% had persistent inspiratory muscle weakness at hospital discharge. Maximal inspiratory pressure (MIP) measured 12 days after diagnosis strongly predicted persistent weakness and may guide early rehabilitation and resource allocation.
Evaluating the Cost-Effectiveness of Early In-Bed Cycling Plus Routine Physiotherapy in Mechanically Ventilated ICU Patients: Insights from the CYCLE Trial
Posted inCritical Care news Rehabilitation Medicine Respiratory

Evaluating the Cost-Effectiveness of Early In-Bed Cycling Plus Routine Physiotherapy in Mechanically Ventilated ICU Patients: Insights from the CYCLE Trial

This economic evaluation from the CYCLE randomized trial found no significant cost or quality-adjusted life-year benefit by adding early in-bed cycling to usual physiotherapy for ICU patients on mechanical ventilation, underscoring a need for further research to clarify its value.
Proportional-Assist Ventilation and Pressure-Support Ventilation: Comparative Impact on Mechanical Ventilation Duration in Critical Care
Posted inClinical Updates Critical Care Specialties

Proportional-Assist Ventilation and Pressure-Support Ventilation: Comparative Impact on Mechanical Ventilation Duration in Critical Care

A comprehensive international trial showed that proportional-assist ventilation (PAV+) does not significantly shorten the time to liberation from mechanical ventilation compared to pressure-support ventilation (PSV) in critically ill adults, with comparable safety and secondary outcomes.