The DOI matches its Crossref record; 16 of the 16 references it cites were found in a registry or an index.
Regional Effects and Mechanism of Positive End-Expiratory Pressure in Early Adult Respiratory Distress Syndrome
Abstract
OBJECTIVE: To test the hypothesis that positive end-expiratory pressure (PEEP) prevents the collapse of a given lung region when it is equal to or greater than the hydrostatic pressure superimposed (SPL) to that region. DESIGN: Intervention study with sequential levels of PEEP applied in random order to a cohort of patients with adult respiratory distress syndrome (ARDS). SETTING: Referral center for ARDS in a university hospital. PATIENTS: Ten ARDS patients (with Murray scores > 2.5). INTERVENTION: Basal computed tomographic (CT) section taken at 0, 2, 4, 5, 6, 8, 10, 12, 14, 15, and 20 cm H2O PEEP. MAIN OUTCOME MEASURES: Basal lung CT sections were divided into 10 equal levels from the ventral to dorsal surfaces. In each level SPL was measured from density and height. The inflation of the level was measured as the gas/tissue ratio (g/t); g/t changes with PEEP were defined as the g/t-P curve. The slope of the g/t-P curve was defined as level compliance (ie, the ratio of change in the g/t of the level to the change in pressure). A linear g/t-P curve was the criterion to detect inflation without recruitment (ie, new pulmonary units opening at a given pressure). A biphasic g/t-P curve (change of compliance after an inflection point) was the criterion to detect recruitment. Pflex was defined as the pressure at which the inflection point occurred. RESULTS: The SPL increased from level 1 (ventral) to level 10 (dorsal) (r = .91; P < .01). The number of linear g/t-P curves decreased from level 1 to level 10 (r = .98; P < .01), while the number of biphasic g/t-P curves increased (r = .95; P < .01). The Pflex increased from level 1 to 10 (r = .97; P < .01) and Pflex was similar to SPL (Pflex = 1.05 + 0.9 SPL; r = .75; P < .01). CONCLUSIONS: The increased SPL causes compression atelectasis; this is prevented when PEEP to a given lung region is equal to or greater than the SPL.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
SNEDECOR, G. W. (1939) · Soil Science · doi:10.1097/00010694-193902000-00006 · Cited by 19,359
ACUTE RESPIRATORY DISTRESS IN ADULTS
Ashbaugh, D., Boyd Bigelow, D., Petty, T., & Levine, B. (1967) · The Lancet · doi:10.1016/s0140-6736(67)90168-7 · Cited by 4,278
An Expanded Definition of the Adult Respiratory Distress Syndrome
Murray, J. F., Matthay, M. A., Luce, J. M., & Flick, M. R. (1988) · American Review of Respiratory Disease · doi:10.1164/ajrccm/138.3.720 · Cited by 2,646
Pepe, P., & Marini, J. J. (1982) · PubMed · doi:10.1164/arrd.1982.126.1.166 · Cited by 672
Gattinoni, L., Pesenti, A., Bombino, M., Baglioni, S., Rivolta, M., Rossi, F., Rossi, G., Fumagalli, R., Marcolin, R., Mascheroni, D., et al. (1988) · Anesthesiology · doi:10.1097/00000542-198812000-00005 · Cited by 664
Self-citationGattinoni, L., Pelosi, P., Vitale, G., Pesenti, A., D'Andrea, L., & Mascheroni, D. (1991) · Anesthesiology · doi:10.1097/00000542-199101000-00004 · Cited by 615
Self-citationPulmonary Densities during Anesthesia with Muscular Relaxation—A Proposal of Atelectasis
Brismar, B., Hedenstierna, G., Lundquist, H., Strandberg, Å., Svensson, L., & Tokics, L. (1985) · Anesthesiology · doi:10.1097/00000542-198504000-00009 · Cited by 582
Total Respiratory Pressure-Volume Curves in the Adult Respiratory Distress Syndrome
Matamis, D., Lemaire, F., Harf, A., Brun-Buisson, C., Ansquer, J. C., & Atlan, G. (1984) · Chest · doi:10.1378/chest.86.1.58 · Cited by 475
Ventilation with end-expiratory pressure in acute lung disease
Falke, K. J., Pontoppidan, H., Kumar, A., Leith, D. E., Geffin, B., & Laver, M. B. (1972) · Journal of Clinical Investigation · doi:10.1172/jci107042 · Cited by 435
Adult respiratory distress syndrome profiles by computed tomography
Gattinoni, L., Presenti, A., Torresin, A., Baglioni, S., Rivolta, M., Rossi, F., Scarani, F., Marcolin, R., & Cappelletti, G. (1986) · Journal of Thoracic Imaging · doi:10.1097/00005382-198607000-00005 · Cited by 297
Self-citation
Cited by
Ranieri, V. M., Suter, P. M., Tortorella, C., De Tullio, R., Dayer, J. M., Brienza, A., Bruno, F., & Slutsky, A. S. (1999) · JAMA · doi:10.1001/jama.282.1.54 · Cited by 1,908
Lung recruitment in patients with the acute respiratory distress syndrome.
Gattinoni, L., Caironi, P., Cressoni, M., Chiumello, D., Ranieri, V. M., Quintel, M., Russo, S., Patroniti, N., Cornejo, R., & Bugedo, G. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa052052 · Cited by 1,548
Self-citationMultiple System Organ Failure: Is Mechanical Ventilation a Contributing Factor?
SLUTSKY, A. S., & TREMBLAY, L. N. (1998) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.157.6.9709092 · Cited by 836
Lung Opening and Closing during Ventilation of Acute Respiratory Distress Syndrome
Caironi, P., Cressoni, M., Chiumello, D., Ranieri, M., Quintel, M., Russo, S. G., Cornejo, R., Bugedo, G., Carlesso, E., Russo, R., et al. (2010) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200905-0787oc · Cited by 358
Self-citationOther approaches to open-lung ventilation: Airway pressure release ventilation
Habashi, N. M. (2005) · Critical Care Medicine · doi:10.1097/01.ccm.0000155920.11893.37 · Cited by 309
Metadata
- Authors
- Gattinoni, L.
- Venue
- JAMA: The Journal of the American Medical Association
- Publisher
- American Medical Association (AMA)
- Published
- 1993-04-28
- Volume
- 269
- Issue
- 16
- Pages
- 2122
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2033088713
- Cited by
- 481
- References
- 16
- FWCI
- 16.91
- Type
- journal article
- Language
- en
- Open access
- closed
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
How to cite
Cite CoChat for the checks on this page, and the paper for its own findings.
- This page
- CoChat. (2026). Citation check: Regional Effects and Mechanism of Positive End-Expiratory Pressure in Early Adult Respiratory Distress Syndrome. https://app.cochat.ai/papers/10.1001/jama.1993.03500160092039
- The paper
- Gattinoni, L. (1993). Regional Effects and Mechanism of Positive End-Expiratory Pressure in Early Adult Respiratory Distress Syndrome. JAMA: The Journal of the American Medical Association. https://doi.org/10.1001/jama.1993.03500160092039
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
