ReviewCritical care (London, England)2025
Assessing inspiratory drive and effort in critically ill patients at the bedside.
Review in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Comparative effects of respiratory stimulants in mechanically ventilated patients: a network meta-analysis of randomized controlled trials.Scientific reports · 2025Pooled it
- Acquisition of respiratory surface EMG: a systematic literature review of electrode configurations and methodological reporting.Critical care (London, England) · 2025Pooled it
- Physiological effects of noninvasive respiratory support strategies in adults with acute hypoxemic respiratory failure: a systematic review and network meta-analysis.Critical care (London, England) · 2025Pooled it
- Noninvasive monitoring of inspiratory effort in mechanical ventilation: a dual-database bibliometric analysis from 1990 to 2025.Frontiers in medicine · 2025Pooled it
- Flow Index Trajectories During Spontaneous Breathing Trials Are Associated With Extubation Failure: A Latent Class Trajectory Modeling Study.Clinical and translational science · 2026Article
- ARDS 60th anniversary: spontaneous breathing in ARDS.Intensive care medicine · 2026Article
- ARDS management beyond the guidelines: a practical physiology-based approach to individualized care.Intensive care medicine · 2026Review
- Dissociation between airway and transpulmonary pressures during external chest wall restriction: a prospective self-controlled physiological study.Journal of thoracic disease · 2026Article
- Liberation from Mechanical Ventilation in Acute Hypoxemic Respiratory Failure or Adult Respiratory Distress Syndrome: A Review.Journal of clinical medicine · 2026Review
- Predicting Failure at Initiation of High-Flow Nasal Oxygen in Patients With COVID-19: Literature Review, Development and Internal Validation of a Prediction Model.Respirology (Carlton, Vic.) · 2026Observational
- Rehabilitating the diaphragm: an integrated approach to intensive care unit-acquired dysfunction in critical illness-a narrative review.Acute and critical care · 2026Article
- Magnitude and pattern of breathing effort during spontaneous breathing trials after cardiac surgery: a physiological model of sustained breathing effort despite diaphragm dysfunction.Critical care (London, England) · 2026Article
- Non-Invasive Respiratory Support in "De Novo" Acute Hypoxemic Respiratory Failure: Which Technique Is Best?Medicina (Kaunas, Lithuania) · 2026Review
- Diaphragm physiological similarity index (DPSI): a de Novo speckle-tracking ultrasound metric for HFNC adjustment in acute respiratory failure.Critical care (London, England) · 2026Article
- Patient Self-Inflicted Lung Injury in ARDS: From Physiological Concept to Clinical Syndrome.Journal of clinical medicine · 2026Review
- Extracorporeal Carbon Dioxide Removal in Acute Respiratory Distress Syndrome: Physiologic Rationale and Phenotype-Based Perspectives.Medicina (Kaunas, Lithuania) · 2026Review
- Respiratory Support in Cardiogenic Pulmonary Edema: Clinical Insights from Cardiology and Intensive Care.Journal of cardiovascular development and disease · 2026Review
- Beyond blood gases: diaphragm-guided sequential non-invasive ventilation for COPD with type II respiratory failure.Frontiers in medicine · 2026Review
- The invasive and non-invasive monitoring of inspiratory effort and drive during assisted mechanical ventilation.Annals of intensive care · 2026Review
- Is Measurement of Inspiratory Effort and Respiratory Mechanics before Ventilator Weaning a Step toward Personalized Medicine?American journal of respiratory and critical care medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
28 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Monitoring inspiratory drive and effort may aid proper selection and setting of respiratory support in patients with acute respiratory failure (ARF), whether they are intubated or not. Although diaphragmatic electrical activity (EAdi) and esophageal manometry can be considered the reference methods for assessing respiratory drive and inspiratory effort, respectively, various alternative techniques exist, each with distinct advantages and limitations. This narrative review provides a comprehensive overview of bedside methods to assess respiratory drive and effort, with a primary focus on patients with ARF. First, EAdi and esophageal manometry are described and discussed as reference techniques. Then, alternative methods are categorized along the neuromechanical pathway from inspiratory drive to muscular effort into three groups: (1) techniques assessing the respiratory drive: airway occlusion pressure (P0.1), mean inspiratory flow (Vt/Ti) and respiratory muscle surface electromyography (sEMG); (2) techniques assessing the respiratory muscle effort: whole-breath occlusion pressure (ΔPocc), pressure-muscle index (PMI), nasal pressure swing (ΔPnose), diaphragm ultrasonography (USdi), central venous pressure swing (ΔCVP), breathing effort (BREF) models, and flow index; (3) techniques and clinical parameters assessing the consequences of effort: tidal volume (Vt), electrical impedance tomography (EIT), dyspnea. For each, we summarize the physiological rationale, measurement methodology, interpretation of results, and key limitations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.