Association between controlled mechanical ventilation and systemic inflammation in acute hypoxemic respiratory failure: an observational cohort study

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dc.article.number482
dc.contributor.authorBachmann Barrón, María Consuelo
dc.contributor.authorBenites, Martín H.
dc.contributor.authorOviedo Álvarez, Vanessa Andrea
dc.contributor.authorHamidi Vadeghani, Majd Niki
dc.contributor.authorSoto Muñoz, Dagoberto Igor
dc.contributor.authorBasoalto Escobar, Roque Ignacio
dc.contributor.authorCruces, Pablo
dc.contributor.authorJalil Contreras, Yorschua Frederick
dc.contributor.authorDamiani Rebolledo, L. Felipe
dc.contributor.authorBugedo Tarraza, Guillermo
dc.contributor.authorBruhn, Alejandro
dc.contributor.authorRetamal Montes, Jaime
dc.date.accessioned2025-12-09T15:11:37Z
dc.date.available2025-12-09T15:11:37Z
dc.date.issued2025
dc.date.updated2025-11-16T01:04:47Z
dc.description.abstractBackground In patients with acute hypoxemic respiratory failure, spontaneous breathing efforts may contribute to patient self-inflicted lung injury through increased ventilation inhomogeneity and systemic inflammation. Whether early transition to controlled mechanical ventilation (CMV) mitigates these effects remains uncertain. Methods This observational, prospective cohort study included 40 ICU patients with acute hypoxemic respiratory failure who initially breathed spontaneously. Based on clinical decisions, patients were managed with either continued spontaneous breathing (SB group, n = 12) or transitioned to CMV (CMV group, n = 28). Arterial blood gases, hemodynamics, plasma cytokines (IL-6 and IL-8), and ventilation distribution via electrical impedance tomography (EIT) were recorded at baseline and after 24 h. In the CMV group, intermediate time points (T2, T6, T12) were also assessed after intubation. The trial was registered in ClinicalTrials.gov (NCT03513809). Results In the CMV group, respiratory rate and heart rate decreased significantly over time. IL-6 levels dropped markedly from 305 ± 938 pg/mL at baseline to 27 ± 58 pg/mL at 24 h (p = 0.0195), accompanied by a significant improvement in oxygenation (PaO₂/FiO₂ from 140 ± 51 to 199 ± 67, p = 0.0004). EIT data showed improved ventilation distribution with increased end-expiratory lung impedance, decreased global inhomogeneity, and a shift in the center of ventilation toward dorsal regions. In contrast, the SB group showed no significant changes over 24 h in gas exchange, systemic inflammation, or EIT-derived parameters. Conclusions In patients with acute hypoxemic respiratory failure initially breathing spontaneously, transition to CMV was associated with reduced IL-6 levels and improved ventilatory homogeneity over 24 h. These exploratory findings indicate that connection to controlled mechanical ventilation was associated with reduced systemic inflammation, a relationship that warrants confirmation in larger prospective studies.
dc.fechaingreso.objetodigital2025-12-09
dc.format.extent14 páginas
dc.fuente.origenAutoarchivo
dc.identifier.citationCritical Care. 2025 Nov 11;29(1):482
dc.identifier.urihttps://doi.org/10.1186/s13054-025-05727-7
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/107310
dc.information.autorucEscuela de Medicina; Bachmann Barrón, María Consuelo; 0000-0002-2006-0591; 215825
dc.information.autorucEscuela de Medicina; Benites, Martín H.; S/I; 1246778
dc.information.autorucEscuela de Medicina; Oviedo Álvarez, Vanessa Andrea; S/I; 1009275
dc.information.autorucEscuela de Ingeniería; Hamidi Vadeghani, Majd Niki; S/I; 1045141
dc.information.autorucEscuela de Medicina; Soto Muñoz, Dagoberto Igor; 0000-0002-7350-1530; 1008458
dc.information.autorucEscuela de Medicina; Basoalto Escobar, Roque Ignacio; 0000-0002-8908-7397; 1010703
dc.information.autorucEscuela de Medicina; Jalil Contreras, Yorschua Frederick; 0000-0002-4993-7158; 1079709
dc.information.autorucEscuela de Medicina; Damiani Rebolledo, L. Felipe; 0000-0002-8338-0488; 237645
dc.information.autorucEscuela de Medicina; Bugedo Tarraza, Guillermo; 0000-0001-7527-6202; 60490
dc.information.autorucEscuela de Medicina; Bruhn, Alejandro; 0000-0001-8034-1937; 741
dc.information.autorucEscuela de Medicina; Retamal Montes, Jaime; 0000-0002-6817-3659; 175147
dc.language.isoen
dc.nota.accesocontenido completo
dc.revistaCritical Care
dc.rightsacceso abierto
dc.rights.holderThe Author(s)
dc.rights.licenseCC BY-NC-ND 4.0 Attribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectAcute hypoxemic respiratory failure
dc.subjectMechanical ventilation
dc.subjectSpontaneous breathing
dc.subjectPatient self-inflicted lung injury
dc.subjectCytokines
dc.subjectElectrical impedance tomography
dc.subject.ddc610
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleAssociation between controlled mechanical ventilation and systemic inflammation in acute hypoxemic respiratory failure: an observational cohort study
dc.typeartículo
dc.volumen29
sipa.codpersvinculados215825
sipa.codpersvinculados1246778
sipa.codpersvinculados1009275
sipa.codpersvinculados1045141
sipa.codpersvinculados1008458
sipa.codpersvinculados1010703
sipa.codpersvinculados1079709
sipa.codpersvinculados237645
sipa.codpersvinculados60490
sipa.codpersvinculados741
sipa.codpersvinculados175147
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