Academic Journal
Waveform data capture substantial variation in tidal volume and other respiratory parameters.
| Τίτλος: | Waveform data capture substantial variation in tidal volume and other respiratory parameters. |
|---|---|
| Συγγραφείς: | Moin EE; Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Philadelphia, PA, United States.; Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PA, United States., Bennett RM; Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Philadelphia, PA, United States.; Penn-CHOP Lung Biology Institute, University of Pennsylvania, Philadelphia, PA, United States.; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, United States., Moffett AT; Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Philadelphia, PA, United States.; Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PA, United States.; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States., Schmid BE; Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PA, United States., Long K; Penn Medicine, Philadelphia, PA, United States., Seewald NJ; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, United States., Reilly JP; Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Philadelphia, PA, United States.; Penn-CHOP Lung Biology Institute, University of Pennsylvania, Philadelphia, PA, United States.; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, United States., Weissman GE; Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Philadelphia, PA, United States.; Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PA, United States.; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States.; Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, United States. |
| Πηγή: | Annals of the American Thoracic Society [Ann Am Thorac Soc] 2026 May 01; Vol. 23 (5), pp. 791-799. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: American Thoracic Society Country of Publication: England NLM ID: 101600811 Publication Model: Print Cited Medium: Internet ISSN: 2325-6621 (Electronic) Linking ISSN: 23256621 NLM ISO Abbreviation: Ann Am Thorac Soc Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, NY : American Thoracic Society, [2013]- |
| Ιατρικοί όροι (MeSH): | Tidal Volume*/physiology , Respiration, Artificial*/methods, Humans ; Retrospective Studies ; Male ; Female ; Electronic Health Records ; Middle Aged ; Aged ; Intensive Care Units |
| Περίληψη: | Rationale: Patients receiving invasive mechanical ventilation (IMV) require accurate assessments of ventilator parameters. Documentation of these parameters in standard practice may fail to capture meaningful variation due to intermittent missingness. Objectives: To assess variation in continuously measured ventilator parameters and agreement with measurements documented as part of routine care in the electronic health record (EHR). Methods: We performed a retrospective cohort study of patients receiving IMV in a medical intensive care unit from November 2024 through March 2025. We compared the observed tidal volume, minute ventilation, peak inspiratory pressure, and positive end-expiratory pressure, measured continuously from device waveforms with intermittent EHR documentation. We calculated descriptive statistics and measures of agreement between these sources. Results: For 59 encounters, the median age was 65 years (IQR, 59-72 years), 33 (56%) patients were male, and 17 (29%) were Black. Thirty-four (58%) patients died or were discharged to hospice. Among 358 patient-days of data, continuous measurements captured significantly more variation than EHR-documented measurements across all parameters. The largest errors were in observed tidal volume (mean absolute error, 69 mL [95% CI, 62-77 mL]; correlation coefficient 0.540). Agreement in tidal volume was worse among patients receiving mandatory modes of ventilation (correlation coefficient 0.454). Conclusions: Intermittent measurement of ventilator parameters fails to capture large variability observed in continuous, waveform-derived measurements. Poor agreement in parameters like tidal volume, even in mandatory modes of ventilation, highlights the potential for ventilator waveform data to improve care and advance research for patients with acute respiratory distress syndrome and others receiving IMV. (© The Author(s) 2026. Published by Oxford University Press on behalf of the American Thoracic Society.) |
| References: | Intensive Care Med. 2016 Sep;42(9):1427-36. (PMID: 27342819) Respir Care. 2024 Jun 28;69(7):773-781. (PMID: 38653558) Chest. 1995 May;107(5):1387-94. (PMID: 7750336) JAMA. 2010 Mar 3;303(9):865-73. (PMID: 20197533) J Crit Care. 2009 Mar;24(1):74-80. (PMID: 19272542) Crit Care Med. 2018 Feb;46(2):e151-e157. (PMID: 29337804) JAMA. 2012 Oct 24;308(16):1651-9. (PMID: 23093163) N Engl J Med. 2012 Oct 4;367(14):1355-60. (PMID: 23034025) Lancet Respir Med. 2014 Aug;2(8):611-20. (PMID: 24853585) Chest. 2003 Dec;124(6):2275-82. (PMID: 14665511) N Engl J Med. 2010 Sep 16;363(12):1107-16. (PMID: 20843245) N Engl J Med. 2015 Feb 19;372(8):747-55. (PMID: 25693014) Lancet Respir Med. 2019 Oct;7(10):870-880. (PMID: 31399381) Intensive Care Med. 2020 Apr;46(4):606-618. (PMID: 32016537) Respir Care. 2024 Jul 24;69(8):1042-1054. (PMID: 39048148) N Engl J Med. 2000 May 4;342(18):1301-8. (PMID: 10793162) Crit Care. 2012 Dec 12;16(2):219. (PMID: 22546221) Am J Respir Crit Care Med. 2024 Jan 1;209(1):24-36. (PMID: 38032683) Learn Health Syst. 2024 Jun 18;9(1):e10439. (PMID: 39822919) Crit Care Med. 2011 Nov;39(11):2452-7. (PMID: 21705886) N Engl J Med. 2019 May 23;380(21):1997-2008. (PMID: 31112383) Am Rev Respir Dis. 1974 Nov;110(5):556-65. (PMID: 4611290) Heart Lung. 2014 May-Jun;43(3):231-43. (PMID: 24794784) Br J Anaesth. 2025 Mar;134(3):693-702. (PMID: 39592365) Intensive Care Med. 2023 Jul;49(7):727-759. (PMID: 37326646) BMJ. 2012 Apr 05;344:e2124. (PMID: 22491953) Intensive Care Med. 2016 Oct;42(10):1567-1575. (PMID: 27620287) JAMA. 2002 Jan 16;287(3):345-55. (PMID: 11790214) Crit Care. 2024 May 14;28(1):164. (PMID: 38745253) Crit Care Med. 1984 Oct;12(10):882-7. (PMID: 6435956) JAMA. 2019 May 28;321(20):2003-2017. (PMID: 31104070) BMC Pulm Med. 2024 Mar 4;24(1):110. (PMID: 38438849) Crit Care Med. 2020 Dec;48(12):1710-1719. (PMID: 33031148) Am J Respir Crit Care Med. 2025 Jun;211(6):966-974. (PMID: 39998496) Chest. 1995 Apr;107(4):1083-8. (PMID: 7705120) Intensive Care Med. 2020 Jun;46(6):1222-1231. (PMID: 32206845) Crit Care Med. 2021 Dec 1;49(12):2090-2101. (PMID: 34115638) Crit Care. 2024 Apr 23;28(1):136. (PMID: 38654391) NEJM Evid. 2023 May;2(5):EVIDoa2200295. (PMID: 38320056) Am J Respir Crit Care Med. 2005 Nov 15;172(10):1241-5. (PMID: 16081547) Intensive Care Med. 2006 Oct;32(10):1515-22. (PMID: 16896854) J Am Med Inform Assoc. 2007 May-Jun;14(3):295-303. (PMID: 17329731) |
| Grant Information: | T32 HL007586 United States HL NHLBI NIH HHS; R35GM155262 United States GM NIGMS NIH HHS; T32HL098054 United States HL NHLBI NIH HHS; United States NH NIH HHS; T32 HL098054 United States HL NHLBI NIH HHS; R35 GM155262 United States GM NIGMS NIH HHS; T32HL007586 United States HL NHLBI NIH HHS; R01 HL155159 United States HL NHLBI NIH HHS; L30 HL181929 United States HL NHLBI NIH HHS; R01HL155159 United States HL NHLBI NIH HHS |
| Contributed Indexing: | Keywords: electronic health records; mechanical ventilation; respiratory failure; tidal volume; ventilator waveforms |
| Entry Date(s): | Date Created: 20260211 Date Completed: 20260707 Latest Revision: 20260813 |
| Update Code: | 20260813 |
| PubMed Central ID: | PMC13152669 |
| DOI: | 10.1093/annalsats/aaoag024 |
| PMID: | 41671100 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 2325-6621 |
|---|---|
| DOI: | 10.1093/annalsats/aaoag024 |