title: Correlation between transition percentage of minute volume (TMV%) and outcome of patients with acute respiratory failure.
abstract: We have previously shown in patients receiving adaptive support ventilation (ASV) that there existed a Transition %MinVol (TMV%) where the patient's work of breathing began to reduce. In this study, we tested the hypothesis that higher TMV% would be associated with poorer outcome in patients with acute respiratory failure.
  
  
  
  In this prospective observational study, we recruited patients with acute respiratory failure on ASV between December 2012 and September 2013 in a mixed ICU. The TMV% was determined by adjusting % MinVol until mandatory respiratory frequency was between 0 and 1breath/min. TMV% was measured on the first two days of mechanical ventilation.
  
  
  
  A total of 337 patients (age: 70±16years) were recruited. In patients whose TMV% increased between Day 1 and Day 2, aOR for mortality was 7.0 (95%CI=2.7-18.3, p<0.001) compared to patients whose TMV% decreased. In patients whose TMV% was unchanged between Day 1 and Day2, aOR for mortality was 3.91 (95%CI=1.80-8.22, p<0.01).
  
  
  
  An increase, or lack of decrease, of TMV% from Day 1 to Day 2 was associated with higher risk of in-hospital death.
authors.affiliation: Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. Electronic address: kanpeng@ndmctsgh.edu.tw.
authors.forename: Chung-Kan
authors.initials: CK
authors.lastname: Peng
authors.affiliation: Department of Critical Care Medicine, Taiwan Landseed Hospital, National Central University, Taoyuan 32449, Taiwan.
authors.forename: Shu-Fen
authors.initials: SF
authors.lastname: Wu
authors.affiliation: Department of Respiratory Therapy, Fu Jen Catholic University, New Taipei, Taiwan. Electronic address: 075147@mail.fju.edu.tw.
authors.forename: Shih-Hsing
authors.initials: SH
authors.lastname: Yang
authors.affiliation: Department of Critical Care Medicine, Taiwan Landseed Hospital, National Central University, Taoyuan 32449, Taiwan. Electronic address: hsiehcf@landseed.com.tw.
authors.forename: Chuan-Fa
authors.initials: CF
authors.lastname: Hsieh
authors.affiliation: Department of Critical Care Medicine, Taiwan Landseed Hospital, National Central University, Taoyuan 32449, Taiwan. Electronic address: huangcc@landseed.com.tw.
authors.forename: Chung-Chih
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Duke University Medical Center, Chapel Hill, NC, USA. Electronic address: yuhchin.huang@duke.edu.
authors.forename: Yuh-Chin T
authors.initials: YT
authors.lastname: Huang
authors.affiliation: Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Critical Care Medicine, Taiwan Landseed Hospital, National Central University, Taoyuan 32449, Taiwan. Electronic address: wucp@landseed.com.tw.
authors.forename: Chin-Pyng
authors.initials: CP
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012119:Respiration; D012121:Respiration, Artificial / Q000401:mortality; D012128:Respiratory Distress Syndrome / Q000401:mortality / Q000503:physiopathology; D012131:Respiratory Insufficiency / Q000401:mortality / Q000503:physiopathology*; D013990:Tidal Volume / Q000502:physiology; D015300:Ventilator Weaning
keywords: Mechanical ventilation; Minute volume; Mortality; Optimal minute volume; Outcome; Weaning