Academic Journal
Use of dual targeting during volume control ventilation is associated with increased delivery of non-lung-protective tidal volumes.
| Τίτλος: | Use of dual targeting during volume control ventilation is associated with increased delivery of non-lung-protective tidal volumes. |
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| Συγγραφείς: | Moodabagil M; Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State Wexner Medical Center, 241 W 11th Ave Suite 5000, Columbus, OH, 43201, USA. Electronic address: Meghana.moodabagil@osumc.edu., Easterling R; Department of Pulmonary, Critical Care, and Sleep Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC, 29425, USA., Carter A; Department of Internal Medicine, The Ohio State Wexner Medical Center, 395 W 12th Ave 3rd Floor, Columbus, OH, 43210, USA., Henricks J; Department of Internal Medicine, The Ohio State Wexner Medical Center, 395 W 12th Ave 3rd Floor, Columbus, OH, 43210, USA., Deol G; Department of Internal Medicine, The Ohio State Wexner Medical Center, 395 W 12th Ave 3rd Floor, Columbus, OH, 43210, USA., Parry T; Department of Emergency Medicine, The Ohio State Wexner Medical Center, 410 W. 10th Ave, Columbus, OH, 43210, USA., Costa A; Division of General Internal Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA., O'Connor B; Department of Internal Medicine, The Ohio State Wexner Medical Center, 395 W 12th Ave 3rd Floor, Columbus, OH, 43210, USA., Wilson M; Department of Internal Medicine, The Ohio State Wexner Medical Center, 395 W 12th Ave 3rd Floor, Columbus, OH, 43210, USA., Hosler Q; Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois Chicago, 840 S Wood Street, Room 920-N CSB, Chicago, IL, 60612, USA., Grami Z; Division of Pulmonary, Allergy and Critical Care Medicine, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, Portland, OR, 97239, USA., Barraza M; Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State Wexner Medical Center, 241 W 11th Ave Suite 5000, Columbus, OH, 43201, USA., Husak A; Division of Pulmonary, Critical Care and Sleep Medicine at University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA., Mireles-Cabodevila E; Departments of Pulmonary and Critical Care Medicine, Integrated Hospital Care Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA., Herman D; Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State Wexner Medical Center, 241 W 11th Ave Suite 5000, Columbus, OH, 43201, USA., Eisinger G; Division of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State Wexner Medical Center, 241 W 11th Ave Suite 5000, Columbus, OH, 43201, USA. |
| Πηγή: | Respiratory medicine [Respir Med] 2026 Sep; Vol. 261, pp. 109068. Date of Electronic Publication: 2026 Jul 29. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: England NLM ID: 8908438 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-3064 (Electronic) Linking ISSN: 09546111 NLM ISO Abbreviation: Respir Med Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2003- : Oxford : Elsevier Original Publication: London : Baillière Tindall, in association with the British Thoracic Society, [c1989- |
| Ιατρικοί όροι (MeSH): | Tidal Volume*/physiology , Respiration, Artificial*/methods , Respiration, Artificial*/instrumentation, Respiratory Distress Syndrome/epidemiology ; Humans ; Retrospective Studies ; Female ; Male ; Middle Aged ; Aged ; Length of Stay ; Intensive Care Units |
| Περίληψη: | Purpose: Dual targeting (DT) is a patient-comfort ventilator feature that allows for increased flow in response to patient demand. Since flow is augmented above the set flow, larger tidal volumes (VT) than set may be delivered. This study assessed the impact of DT on the ability to maintain delivered VT ≤ 8 mL/kg of ideal body weight (IBW). Materials and Methods: This was a single center retrospective cohort study of medical ICU patients receiving volume-targeted mechanical ventilation in the year before and after system-wide implementation of a ventilator featuring DT. The primary outcome was the proportion of patients receiving an average VT > 8 mL/kg IBW during the first 48 h of intubation. Secondary outcomes included differences in set versus delivered VT and patient outcomes such as ventilator-free days, incidence of acute respiratory distress syndrome, mortality, and length of stay. Results: After applying exclusion criteria, 274 patients remained in the analysis, 136 in the control group and 138 in the DT group. Despite no difference in the set VT (median 6.1 mL/kg IBW), patients in the DT group were more likely to receive an average VT > 8 mL/kg IBW (26.1% vs 12.5%, odds ratio 2.5, 95%CI 1.3 - 4.7; P = .006). Median delivered VT was higher with DT (7.2 vs 6.6 mL/kg IBW; P < .001), as was median difference between set and delivered VT (+53.3 vs + 27.5 mL; P < .001). These differences remained significant after adjustment for baseline characteristics. However, no significant differences in patient outcomes were observed after adjustment. Conclusions: DT was associated with more frequent delivery of larger VT than recommended for lung protection. Further studies are needed to assess the downstream impacts on patient outcomes. (Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Acute respiratory distress syndrome; Dual targeting; Low tidal volume; Lung protective ventilation; Mechanical ventilation |
| Entry Date(s): | Date Created: 20260729 Date Completed: 20260812 Latest Revision: 20260812 |
| Update Code: | 20260813 |
| DOI: | 10.1016/j.rmed.2026.109068 |
| PMID: | 42526703 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1532-3064 |
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| DOI: | 10.1016/j.rmed.2026.109068 |