![]() ![]() Patients were randomized to the no-sigh group and treated by PSV alone, or to the sigh group, treated by PSV plus sigh (increase in airway pressure to 30 cm H 2O for 3 s once per minute) until day 28 or death or successful spontaneous breathing trial. We conducted a multicenter noninferiority randomized clinical trial on adult intubated patients with acute hypoxemic respiratory failure or ARDS undergoing PSV. Is the clinical application of sigh during pressure support ventilation (PSV) feasible? Sigh is a cyclic brief recruitment maneuver: previous physiologic studies showed that its use could be an interesting addition to pressure support ventilation to improve lung elastance, decrease regional heterogeneity, and increase release of surfactant. 30 Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.29 Servei de Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.28 Médecine Intensive-Réanimation Groupement Hospitalier Edouard Herriot, Université de Lyon Faculté de Médecine Lyon-Est, Lyon, France.27 Sorbonne University, GRC 29, AP-HP, DMU DREAM, Department of Anesthesiology and Critical Care, Pitié-Salpêtrière Hospital, Paris, France.26 Intensive Care Department, Hospital da Mulher, Salvador, Bahia, Brazil Intensive Care Department, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil.25 Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.24 Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy.23 Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany.22 Intensive Care Unit, Larissa General Hospital, Larissa, Greece.21 Critical Care Service, Anaesthetics Division, Barking Havering and Redbridge University Hospitals NHS Trust, London, United Kingdom.20 Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, IRCCS Fondazione Policlinico A.19 Critical Care Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain Ciber Enfermedades Respiratorias (CibeRes), Instituto de Salud Carlos III, Madrid, Spain.18 Hospital Universitario Fundación Jiménez Díaz de Madrid, Madrid, Spain.17 AUSL Toscana Centro, Unit of Anesthesia and Resuscitation, San Giuseppe Hospital, Empoli, Italy.16 Department of Anesthesiology, Intensive Care and Transplants, University Hospital St.15 Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.14 Section of Anesthesia, Analgesia, Intensive Care and Emergency, Department of Surgical, Oncological and Oral Science, Policlinico Paolo Giaccone, University of Palermo, Palermo, Italy.13 Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Milan, Italy.12 Center for Internal Intensive Medicine, University Medical Center Ljubljana, Ljubljana, Slovenia.11 Anesthesia and Intensive Care, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.10 Department of Medicine-DIMED, University of Padua, Padua, Italy Institute of Anesthesia and Intensive Care, Padua Hospital, Padua, Italy.9 Anesthesia and Critical Care, San Gerardo Hospital, ASST Monza, Italy.8 Morphology, Surgery and Experimental Medicine, Anesthesia and Intensive Care Unit, University of Ferrara, Ferrara, Italy.7 Department of Anesthesia, Critical Care and Emergency, Foundation IRCCS Cà Granda Maggiore Policlinico Hospital, Milan, Italy.6 Anesthesia and Critical Care Service 1, Niguarda Hospital, Milan, Italy. ![]() 5 School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy Anesthesia and Critical Care Service 1, Niguarda Hospital, Milan, Italy. ![]()
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