Effect of decreasing respiratory rate on the mechanical power of ventilation and lung injury biomarkers: a randomized cross-over clinical study in COVID-19 ARDS patients

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dc.article.number69
dc.catalogadorpva
dc.contributor.authorDamiani Rebolledo, L. Felipe
dc.contributor.authorBasoalto Escobar, Roque Ignacio
dc.contributor.authorOviedo Álvarez, Vanessa Andrea
dc.contributor.authorAlegría Vargas, Leyla
dc.contributor.authorSoto Muñoz, Dagoberto Igor
dc.contributor.authorBachmann Barrón, María Consuelo
dc.contributor.authorJalil Contreras, Yorschua Frederick
dc.contributor.authorSantis Fuentes, César Antonio
dc.contributor.authorCarpio Cordero, David Bernardo
dc.contributor.authorUlloa Morrison, Rodrigo
dc.contributor.authorValenzuela Espinoza, Emilio Daniel
dc.contributor.authorVera Alarcón, María Magdalena
dc.contributor.authorSchultz, Marcus J.
dc.contributor.authorRetamal Montes, Jaime
dc.contributor.authorBruhn, Alejandro
dc.contributor.authorBugedo Tarraza, Guillermo
dc.date.accessioned2025-07-29T17:18:35Z
dc.date.available2025-07-29T17:18:35Z
dc.date.issued2025
dc.date.updated2025-07-28T12:13:46Z
dc.description.abstractBackground The respiratory rate (RR) is a key determinant of the mechanical power of ventilation (MP). The effect of reducing the RR on MP and its potential to mitigate ventilator-induced lung injury remains unclear. Objectives To compare invasive ventilation using a lower versus a higher RR with respect to MP and plasma biomarkers of lung injury in COVID-19 ARDS patients. Methods In a randomized cross-over clinical study in COVID-19 ARDS patients, we compared ventilation using a lower versus a higher RR in time blocks of 12 h. Patients were ventilated with tidal volumes of 6 ml/kg predicted body weight, and positive-end-expiratory pressure and fraction of inspired oxygen according to an ARDS network table. Respiratory mechanics and hemodynamics were assessed at the end of each period, and blood samples were drawn for measurements of inflammatory cytokines, epithelial and endothelial lung injury markers. In a subgroup of patients, we performed echocardiography and esophageal pressure measurements. Results We enrolled a total of 32 patients (26 males [81%], aged 52 [44–64] years). The median respiratory rate during ventilation with a lower and a higher RR was 20 [16–22] vs. 30 [26–32] breaths/min (p < 0.001), associated with a lower median minute ventilation (7.3 [6.5–8.5] vs. 11.6 [10–13] L/min [p < 0.001]) and a lower median MP (15 [11–18] vs. 25 [21–32] J/min [p < 0.001]). No differences were observed in any inflammatory (IL-6, IL-8, and TNF-R1), epithelial (s-RAGE and SP-D), endothelial (Angiopoietin-2), or pro-fibrotic activity (TGF-ß) marker between high or low RR. Cardiac function by echocardiography, and respiratory mechanics using esophageal pressure measurements were also not different. Conclusions Reducing the respiratory rate decreases mechanical power in COVID-19 ARDS patients but does not reduce plasma lung injury biomarkers levels in this cross-over study. Study registration This study is registered at clinicaltrials.gov (study identifier NCT04641897)
dc.fechaingreso.objetodigital2025-07-28
dc.format.extent11 páginas
dc.fuente.origenBiomed Central
dc.identifier.citationIntensive Care Medicine Experimental. 2025 Jul 09;13(1):69
dc.identifier.doi10.1186/s40635-025-00782-4
dc.identifier.urihttps://doi.org/10.1186/s40635-025-00782-4
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/105056
dc.information.autorucEscuela de Medicina; Damiani Rebolledo, L. Felipe; 0000-0002-8338-0488; 237645
dc.information.autorucEscuela de Medicina; Basoalto Escobar, Roque Ignacio; 0000-0002-8908-7397; 1010703
dc.information.autorucEscuela de Medicina; Oviedo Álvarez, Vanessa Andrea; S/I; 1009275
dc.information.autorucEscuela de Medicina; Alegría Vargas, Leyla; 0000-0002-0930-4452; 121090
dc.information.autorucEscuela de Medicina; Soto Muñoz, Dagoberto Igor; 0000-0002-7350-1530; 1008458
dc.information.autorucEscuela de Medicina; Bachmann Barrón, María Consuelo; 0000-0002-2006-0591; 215825
dc.information.autorucEscuela de Medicina; Jalil Contreras, Yorschua Frederick; 0000-0002-4993-7158; 1079709
dc.information.autorucEscuela de Medicina; Santis Fuentes, César Antonio; S/I; 1022040
dc.information.autorucEscuela de Medicina; Carpio Cordero, David Bernardo; 0000-0002-9329-8285; 1015466
dc.information.autorucEscuela de Medicina; Ulloa Morrison, Rodrigo; 0009-0005-5850-0686; 1080280
dc.information.autorucEscuela de Medicina; Valenzuela Espinoza, Emilio Daniel; 0000-0001-9758-3473; 1056714
dc.information.autorucEscuela de Medicina; Vera Alarcón, María Magdalena; 0000-0002-2969-3408; 226652
dc.information.autorucEscuela de Medicina; Retamal Montes, Jaime; 0000-0002-6817-3659; 175147
dc.information.autorucEscuela de Medicina; Bruhn, Alejandro; 0000-0001-8034-1937; 741
dc.information.autorucEscuela de Medicina; Bugedo Tarraza, Guillermo; 0000-0001-7527-6202; 60490
dc.issue.numero1
dc.language.isoen
dc.nota.accesocontenido completo
dc.publisherSpringer Nature
dc.revistaIntensive Care Medicine Experimental
dc.rightsacceso abierto
dc.rights.holderThe Author(s)
dc.rights.licenseAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectARDS
dc.subjectInvasive ventilation
dc.subjectRespiratory rate
dc.subjectMechanical power of ventilation
dc.subjectMP
dc.subjectVentilator-induced lung injury
dc.subjectVILI
dc.subjectLung injury biomarkers
dc.subject.ddc610
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleEffect of decreasing respiratory rate on the mechanical power of ventilation and lung injury biomarkers: a randomized cross-over clinical study in COVID-19 ARDS patients
dc.typeartículo
dc.volumen13
sipa.codpersvinculados237645
sipa.codpersvinculados1010703
sipa.codpersvinculados1009275
sipa.codpersvinculados121090
sipa.codpersvinculados1008458
sipa.codpersvinculados215825
sipa.codpersvinculados1079709
sipa.codpersvinculados1022040
sipa.codpersvinculados1015466
sipa.codpersvinculados1080280
sipa.codpersvinculados1056714
sipa.codpersvinculados226652
sipa.codpersvinculados175147
sipa.codpersvinculados741
sipa.codpersvinculados60490
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