Covid-19 Research

Mini Review

Non-Ventilatory Co-Factors of Ventilator-Induced Lung Injury

Journal of Biomedical Research & Environmental Sciences article abstract with citation details, DOI, publication dates, subject areas, full text links, and references.

View DOI Submit Manuscript

Article Details

Publication record, authors, dates, abstract, and full text access.

Open Access
Article Type Mini Review
Subject Medicine Group
OCLC JBRES Record
Lauren Thornton DO* and John J Marini MD
Issue: Volume3-Issue12
Pages: 1578-1588
Received: 2022-12-27
Accepted: 2022-12-30
Published: 2022-12-31

Abstract

Numerous experimental studies demonstrate key aspects of mechanical ventilation which initiate or exacerbate acute lung injury, characterized by proteinaceous edema, inflammation, and hemorrhage. The great majority of these investigations into Ventilator-Induced Lung Injury (VILI) have focused on the characteristics of mechanical ventilation directly regulated by the clinician, including the individual tidal cycle-tidal volume, inspiratory flow rate, driving Pressure and End-Expiratory airway Pressure (PEEP).

FullText HTML FullText PDF DOI: 10.37871/jbres1639 Crossmark

Certificate of Publication

Certificate of Publication

Copyright

© 2022 Thornton L, et al. Distributed under Creative Commons CC-BY 4.0 Creative CommonsAttribution

How to cite this article

Thornton L, Marini JJ. Non-Ventilatory Co-Factors of Ventilator-Induced Lung Injury. 2022 Dec 31; 3(12): 1578-1588. doi: 10.37871/jbres1639, Article ID: JBRES1639, Available at: https://www.jelsciences.com/articles/jbres1639.pdf

Subject area(s)

PathologyRespiratory MedicinePulmonology

References

  1. Gattinoni L, Tonetti T, Cressoni M, Cadringher P, Herrmann P, Moerer O, Protti A, Gotti M, Chiurazzi C, Carlesso E, Chiumello D, Quintel M. Ventilator-related causes of lung injury: the mechanical power. Intensive Care Med. 2016 Oct;42(10):1567-1575. doi: 10.1007/s00134-016-4505-2. Epub 2016 Sep 12. PMID: 27620287.
  2. Brower RG, Matthay M, Schoenfeld D. Meta-analysis of acute lung injury and acute respiratory distress syndrome trials. Am J Respir Crit Care Med. 2002 Dec 1;166(11):1515-7. doi: 10.1164/ajrccm.166.11.340. PMID: 12450936.
  3. Acute Respiratory Distress Syndrome Network, Brower RG, Matthay MA, Morris A, Schoenfeld D, Thompson BT, Wheeler A. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000 May 4;342(18):1301-8. doi: 10.1056/NEJM200005043421801. PMID: 10793162.
  4. Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino GP, Lorenzi-Filho G, Kairalla RA, Deheinzelin D, Munoz C, Oliveira R, Takagaki TY, Carvalho CR. Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med. 1998 Feb 5;338(6):347-54. doi: 10.1056/NEJM199802053380602. PMID: 9449727.
  5. Ricard JD, Dreyfuss D, Saumon G. Ventilator-induced lung injury. Eur Respir J. 2003;22(S42); 2s-9s.
  6. Ricard JD, Dreyfuss D. Cytokines during ventilator-induced lung injury: a word of caution. Anesth Analg. 2001;93;251-252.
  7. Martynowicz MA, Minor TA, Walters BJ, Hubmayr RD. Regional expansion of oleic acid-injured lungs. Am J Respir Crit Care Med. 1999 Jul;160(1):250-8. doi: 10.1164/ajrccm.160.1.9808101. PMID: 10390408.
  8. Ranieri VM, Suter PM, Tortorella C, De Tullio R, Dayer JM, Brienza A, Bruno F, Slutsky AS. Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: a randomized controlled trial. JAMA. 1999 Jul 7;282(1):54-61. doi: 10.1001/jama.282.1.54. PMID: 10404912.
  9. Nunn JF. Distribution of pulmonary ventilation and perfusion. Chapter 8 in: Nunn’s Applied Respiratory Physiology-4th Ed., 1993;156-197.
  10. Pelosi P, Tubiolo D, Mascheroni D, Vicardi P, Crotti S, Valenza F, Gattinoni L. Effects of the prone position on respiratory mechanics and gas exchange during acute lung injury. Am J Respir Crit Care Med. 1998 Feb;157(2):387-93. doi: 10.1164/ajrccm.157.2.97-04023. PMID: 9476848.
  11. Gattinoni L, Pelosi P, Crotti S, Valenza F. Effects of positive end-expiratory pressure on regional distribution of tidal volume and recruitment in adult respiratory distress syndrome. Am J Respir Crit Care Med. 1995 Jun;151(6):1807-14. doi: 10.1164/ajrccm.151.6.7767524. PMID: 7767524.
  12. Marini JJ, Culver BH, Butler J. Mechanical effect of lung distention with positive pressure on cardiac function. Am Rev Respir Dis. 1981 Oct;124(4):382-6. doi: 10.1164/arrd.1981.124.4.382. PMID: 7027851.
  13. Broccard A, Shapiro RS, Schmitz LL, Adams AB, Nahum A, Marini JJ. Prone positioning attenuates and redistributes ventilator-induced lung injury in dogs. Crit Care Med. 2000 Feb;28(2):295-303. doi: 10.1097/00003246-200002000-00001. PMID: 10708156.
  14. Johansson MJ, Wiklund A, Flatebø T, Nicolaysen A, Nicolaysen G, Walther SM. Positive end-expiratory pressure affects regional redistribution of ventilation differently in prone and supine sheep. Crit Care Med. 2004 Oct;32(10):2039-44. doi: 10.1097/01.ccm.0000142395.82277.6f. PMID: 15483412.
  15. Gattinoni L, Tognoni G, Pesenti A, Taccone P, Mascheroni D, Labarta V, Malacrida R, Di Giulio P, Fumagalli R, Pelosi P, Brazzi L, Latini R; Prone-Supine Study Group. Effect of prone positioning on the survival of patients with acute respiratory failure. N Engl J Med. 2001 Aug 23;345(8):568-73. doi: 10.1056/NEJMoa010043. PMID: 11529210.
  16. Chatte G, Sab JM, Dubois JM, Sirodot M, Gaussorgues P, Robert D. Prone position in mechanically ventilated patients with severe acute respiratory failure. Am J Respir Crit Care Med. 1997 Feb;155(2):473-8. doi: 10.1164/ajrccm.155.2.9032181. PMID: 9032181.
  17. Gattinoni L, Vagginelli F, Carlesso E, Taccone P, Conte V, Chiumello D, Valenza F, Caironi P, Pesenti A; Prone-Supine Study Group. Decrease in PaCO2 with prone position is predictive of improved outcome in acute respiratory distress syndrome. Crit Care Med. 2003 Dec;31(12):2727-33. doi: 10.1097/01.CCM.0000098032.34052.F9. PMID: 14668608.
  18. Mancebo J, Fernández R, Blanch L, Rialp G, Gordo F, Ferrer M, Rodríguez F, Garro P, Ricart P, Vallverdú I, Gich I, Castaño J, Saura P, Domínguez G, Bonet A, Albert RK. A multicenter trial of prolonged prone ventilation in severe acute respiratory distress syndrome. Am J Respir Crit Care Med. 2006 Jun 1;173(11):1233-9. doi: 10.1164/rccm.200503-353OC. Epub 2006 Mar 23. PMID: 16556697.
  19. Guérin C, Reignier J, Richard JC, Beuret P, Gacouin A, Boulain T, Mercier E, Badet M, Mercat A, Baudin O, Clavel M, Chatellier D, Jaber S, Rosselli S, Mancebo J, Sirodot M, Hilbert G, Bengler C, Richecoeur J, Gainnier M, Bayle F, Bourdin G, Leray V, Girard R, Baboi L, Ayzac L; PROSEVA Study Group. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med. 2013 Jun 6;368(23):2159-68. doi: 10.1056/NEJMoa1214103. Epub 2013 May 20. PMID: 23688302.
  20. Ehrmann S, Li J, Ibarra-Estrada M, Perez Y, Pavlov I, McNicholas B, Roca O, Mirza S, Vines D, Garcia-Salcido R, Aguirre-Avalos G, Trump MW, Nay MA, Dellamonica J, Nseir S, Mogri I, Cosgrave D, Jayaraman D, Masclans JR, Laffey JG, Tavernier E; Awake Prone Positioning Meta-Trial Group. Awake prone positioning for COVID-19 acute hypoxaemic respiratory failure: a randomised, controlled, multinational, open-label meta-trial. Lancet Respir Med. 2021 Dec;9(12):1387-1395. doi: 10.1016/S2213-2600(21)00356-8. Epub 2021 Aug 20. PMID: 34425070; PMCID: PMC8378833.
  21. Shelhamer MC, Wesson PD, Solari IL, Jensen DL, Steele WA, Dimitrov VG, Kelly JD, Aziz S, Gutierrez VP, Vittinghoff E, Chung KK, Menon VP, Ambris HA, Baxi SM. Prone Positioning in Moderate to Severe Acute Respiratory Distress Syndrome Due to COVID-19: A Cohort Study and Analysis of Physiology. J Intensive Care Med. 2021 Feb;36(2):241-252. doi: 10.1177/0885066620980399. PMID: 33380236; PMCID: PMC7780273.
  22. Tobin MJ. Mechanical ventilation. N Engl J Med. 1994;330;1056-1061.
  23. Laffey JG, O'Croinin D, McLoughlin P, Kavanagh BP. Permissive hypercapnia--role in protective lung ventilatory strategies. Intensive Care Med. 2004 Mar;30(3):347-56. doi: 10.1007/s00134-003-2051-1. Epub 2004 Jan 14. PMID: 14722644.
  24. Madotto F, Rezoagli E, McNicholas BA, Pham T, Slutsky AS, Bellani G, Laffey JG; LUNG SAFE Investigators and the ESICM Trials Group. Patterns and Impact of Arterial CO2 Management in Patients With Acute Respiratory Distress Syndrome: Insights From the LUNG SAFE Study. Chest. 2020 Nov;158(5):1967-1982. doi: 10.1016/j.chest.2020.05.605. Epub 2020 Jun 24. PMID: 32589951.
  25. Laffey JG, Kavanagh BP. Carbon dioxide and the critically ill--too little of a good thing? Lancet. 1999 Oct 9;354(9186):1283-6. doi: 10.1016/S0140-6736(99)02388-0. PMID: 10520649.
  26. Laffey JG, Tanaka M, Engelberts D, Luo X, Yuan S, Tanswell AK, Post M, Lindsay T, Kavanagh BP. Therapeutic hypercapnia reduces pulmonary and systemic injury following in vivo lung reperfusion. Am J Respir Crit Care Med. 2000 Dec;162(6):2287-94. doi: 10.1164/ajrccm.162.6.2003066. PMID: 11112153.
  27. Adding LC, Agvald P, Persson MG, Gustafsson LE. Regulation of pulmonary nitric oxide by carbon dioxide is intrinsic to the lung. Acta Physiol Scand. 1999 Oct;167(2):167-74. doi: 10.1046/j.1365-201x.1999.00585.x. PMID: 10571553.
  28. Shibata K, Cregg N, Engelberts D, Takeuchi A, Fedorko L, Kavanagh BP. Hypercapnic acidosis may attenuate acute lung injury by inhibition of endogenous xanthine oxidase. Am J Respir Crit Care Med. 1998 Nov;158(5 Pt 1):1578-84. doi: 10.1164/ajrccm.158.5.9804039. PMID: 9817711.
  29. Takeshita K, Suzuki Y, Nishio K, Takeuchi O, Toda K, Kudo H, Miyao N, Ishii M, Sato N, Naoki K, Aoki T, Suzuki K, Hiraoka R, Yamaguchi K. Hypercapnic acidosis attenuates endotoxin-induced nuclear factor-[kappa]B activation. Am J Respir Cell Mol Biol. 2003 Jul;29(1):124-32. doi: 10.1165/rcmb.2002-0126OC. Epub 2003 Feb 6. PMID: 12600832.
  30. Holmes JM, Duffner LA, Kappil JC. The effect of raised inspired carbon dioxide on developing rat retinal vasculature exposed to elevated oxygen. Curr Eye Res. 1994 Oct;13(10):779-82. doi: 10.3109/02713689409047013. PMID: 7842726.
  31. Broccard AF, Hotchkiss JR, Vannay C, Markert M, Sauty A, Feihl F, Schaller MD. Protective effects of hypercapnic acidosis on ventilator-induced lung injury. Am J Respir Crit Care Med. 2001 Sep 1;164(5):802-6. doi: 10.1164/ajrccm.164.5.2007060. PMID: 11549536.
  32. Sinclair SE, Kregenow DA, Lamm WJ, Starr IR, Chi EY, Hlastala MP. Hypercapnic acidosis is protective in an in vivo model of ventilator-induced lung injury. Am J Respir Crit Care Med. 2002 Aug 1;166(3):403-8. doi: 10.1164/rccm.200112-117OC. PMID: 12153979.
  33. Laffey J, Engelberts D, Kavanach. Buffering hypercapnic acidosis worsens acute lung injury. Am J respir Crit Care Med. 2000;161;141-146.
  34. Lang JD Jr, Chumley P, Eiserich JP, Estevez A, Bamberg T, Adhami A, Crow J, Freeman BA. Hypercapnia induces injury to alveolar epithelial cells via a nitric oxide-dependent pathway. Am J Physiol Lung Cell Mol Physiol. 2000 Nov;279(5):L994-1002. doi: 10.1152/ajplung.2000.279.5.L994. PMID: 11053037.
  35. Zhu S, Basiouny KF, Crow JP, Matalon S. Carbon dioxide enhances nitration of surfactant protein A by activated alveolar macrophages. Am J Physiol Lung Cell Mol Physiol. 2000 May;278(5):L1025-31. doi: 10.1152/ajplung.2000.278.5.L1025. PMID: 10781434.
  36. Gores GJ, Nieminen AL, Fleishman KE, Dawson TL, Herman B, Lemasters JJ. Extracellular acidosis delays onset of cell death in ATP-depleted hepatocytes. Am J Physiol. 1988 Sep;255(3 Pt 1):C315-22. doi: 10.1152/ajpcell.1988.255.3.C315. PMID: 3421314.
  37. Nin N, Muriel A, Peñuelas O, Brochard L, Lorente JA, Ferguson ND, Raymondos K, Ríos F, Violi DA, Thille AW, González M, Villagomez AJ, Hurtado J, Davies AR, Du B, Maggiore SM, Soto L, D'Empaire G, Matamis D, Abroug F, Moreno RP, Soares MA, Arabi Y, Sandi F, Jibaja M, Amin P, Koh Y, Kuiper MA, Bülow HH, Zeggwagh AA, Anzueto A, Sznajder JI, Esteban A; VENTILA Group. Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome. Intensive Care Med. 2017 Feb;43(2):200-208. doi: 10.1007/s00134-016-4611-1. Epub 2017 Jan 20. PMID: 28108768; PMCID: PMC5630225.
  38. Marini JJ, Hotchkiss J, Broccard A. Bench-to-bedside review: Microvascular and airspace linkage in ventilator-induced lung injury. Critical Care. 2003;7:435-444.
  39. Broccard AF, Hotchkiss JR, Suzuki S, Olson D, Marini JJ. Effects of mean airway pressure and tidal excursion on lung injury induced by mechanical ventilation in an isolated perfused rabbit lung model. Crit Care Med. 1999 Aug;27(8):1533-41. doi: 10.1097/00003246-199908000-00022. PMID: 10470761.
  40. Broccard AF, Hotchkiss JR, Kuwayama N, Olson DA, Jamal S, Wangensteen DO, Marini JJ. Consequences of vascular flow on lung injury induced by mechanical ventilation. Am J Respir Crit Care Med. 1998 Jun;157(6 Pt 1):1935-42. doi: 10.1164/ajrccm.157.6.9612006. PMID: 9620930.
  41. Hotchkiss JR Jr, Blanch L, Murias G, Adams AB, Olson DA, Wangensteen OD, Leo PH, Marini JJ. Effects of decreased respiratory frequency on ventilator-induced lung injury. Am J Respir Crit Care Med. 2000 Feb;161(2 Pt 1):463-8. doi: 10.1164/ajrccm.161.2.9811008. PMID: 10673186.
  42. Hotchkiss JR Jr, Blanch L, Naveira A, Adams AB, Carter C, Olson DA, Leo PH, Marini JJ. Relative roles of vascular and airspace pressures in ventilator-induced lung injury. Crit Care Med. 2001 Aug;29(8):1593-8. doi: 10.1097/00003246-200108000-00016. PMID: 11505134.
  43. Dreyfuss D, Saumon G. Ventilator-induced lung injury: lessons from experimental studies. Am J Respir Crit Care Med. 1998 Jan;157(1):294-323. doi: 10.1164/ajrccm.157.1.9604014. PMID: 9445314.
  44. Dreyfuss D, Saumon G. Role of tidal volume, FRC, and end-inspiratory volume in the development of pulmonary edema following mechanical ventilation. Am Rev Respir Dis. 1993 Nov;148(5):1194-203. doi: 10.1164/ajrccm/148.5.1194. PMID: 8239153. 45.
  45. Broccard A, Vannay Ch, Feihl F, Schaller M. Impact of low pulmonary vascular pressure on ventilator induced lung injury. Crit Care Med. 2002;30(10);2183-2190.
  46. West JB. Regional differences in gas exchange in the lung of erect man. J Appl Physiol. 1962;17:893-901.
  47. Potus F, Mai V, Lebret M, Malenfant S, Breton-Gagnon E, Lajoie AC, Boucherat O, Bonnet S, Provencher S. Novel insights on the pulmonary vascular consequences of COVID-19. Am J Physiol Lung Cell Mol Physiol. 2020 Aug 1;319(2):L277-L288. doi: 10.1152/ajplung.00195.2020. Epub 2020 Jun 17. PMID: 32551862; PMCID: PMC7414237.
  48. Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, Vanstapel A, Werlein C, Stark H, Tzankov A, Li WW, Li VW, Mentzer SJ, Jonigk D. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. N Engl J Med. 2020 Jul 9;383(2):120-128. doi: 10.1056/NEJMoa2015432. Epub 2020 May 21. PMID: 32437596; PMCID: PMC7412750.
  49. Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, Smith K. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med. 2002 Feb 21;346(8):557-63. doi: 10.1056/NEJMoa003289. PMID: 11856794.
  50. McCormick PH, Chen G, Tlerney S, Kelly CJ, Bouchier-Hayes DJ. Clinically relevant thermal preconditioning attenuates ischemia-reperfusion injury. J Surg Res. 2003 Jan;109(1):24-30. doi: 10.1016/s0022-4804(02)00035-5. PMID: 12591231.
  51. Yoo CG, Lee S , Lee CT. Anti-inflammatory effect of HSP induction. J Immu. 2000;164;5416.
  52. Koh Y, Lim CM, Kim MJ, Shim TS, Lee SD, Kim WS, Kim DS, Kim WD. Heat shock response decreases endotoxin-induced acute lung injury in rats. Respirology. 1999 Dec;4(4):325-30. doi: 10.1046/j.1440-1843.1999.00200.x. PMID: 10612564.
  53. Ribeiro SP, Rhee K, Tremblay L, Veldhuizen R, Lewis JF, Slutsky AS. Heat stress attenuates ventilator-induced lung dysfunction in an ex vivo rat lung model. Am J Respir Crit Care Med. 2001 May;163(6):1451-6. doi: 10.1164/ajrccm.163.6.9908076. PMID: 11371417.
  54. Villar J, Ribeiro SP, Mullen JB, Kuliszewski M, Post M, Slutsky AS. Induction of the heat shock response reduces mortality rate and organ damage in a sepsis-induced acute lung injury model. Crit Care Med. 1994 Jun;22(6):914-21. PMID: 8205824.
  55. Silva PL, Moraes L, Santos RS, Samary C, Ramos MB, Santos CL, Morales MM, Capelozzi VL, Garcia CS, de Abreu MG, Pelosi P, Marini JJ, Rocco PR. Recruitment maneuvers modulate epithelial and endothelial cell response according to acute lung injury etiology. Crit Care Med. 2013 Oct;41(10):e256-65. doi: 10.1097/CCM.0b013e31828a3c13. PMID: 23887231.
  56. Felix NS, Samary CS, Cruz FF, Rocha NN, Fernandes MVS, Machado JA, Bose-Madureira RL, Capelozzi VL, Pelosi P, Silva PL, Marini JJ, Rocco PRM. Gradually Increasing Tidal Volume May Mitigate Experimental Lung Injury in Rats. Anesthesiology. 2019 May;130(5):767-777. doi: 10.1097/ALN.0000000000002630. PMID: 30870161.
  57. Fernandes MVS, Rocha NN, Felix NS, Rodrigues GC, Silva LHA, Coelho MS, Fonseca ACF, Teixeira ACGM, Capelozzi VL, Pelosi P, Silva PL, Marini JJ, Rocco PRM. A more gradual positive end-expiratory pressure increase reduces lung damage and improves cardiac function in experimental acute respiratory distress syndrome. J Appl Physiol (1985). 2022 Feb 1;132(2):375-387. doi: 10.1152/japplphysiol.00613.2021. Epub 2021 Dec 23. PMID: 34941443.
  58. Xavier PH, Fernandes Fonseca AC, Gonçalves LA, de Sousa GC, Coelho da Silva M, de Magalhães Sacramento RF, Dos Santos Samary C, Medeiros M, Cruz FF, Capelozzi VL, Felix NS, Pelosi P, Marini JJ, Rocco PRM, Silva PL. Lung injury is induced by abrupt increase in respiratory rate but prevented by recruitment maneuver in mild acute respiratory distress syndrome in rats. Anesthesiology. 2022 Dec 26. doi: 10.1097/ALN.0000000000004479. Epub ahead of print. PMID: 36571572.
  59. Suzuki S, Hotchkiss JR, Toshimichi T, Olson D, Adams AB, Marini JJ. Effect of core body temperature on ventilator-induced lung injury. Crit Care Med. 2004;32(1):144-149.
  60. Akinci OI, Celik M, Mutlu GM, Martino JM, Tugrul S, Ozcan PE, Yilmazbayhan D, Yeldandi AV, Turkoz KH, Kiran B, Telci L, Cakar N. Effects of body temperature on ventilator-induced lung injury. J Crit Care. 2005 Mar;20(1):66-73. doi: 10.1016/j.jcrc.2004.11.001. PMID: 16015518.
  61. Hong SB, Koh Y, Lee IC, Kim MJ, Kim WS, Kim DS, Kim WD, Lim CM. Induced hypothermia as a new approach to lung rest for the acutely injured lung. Crit Care Med. 2005 Sep;33(9):2049-55. doi: 10.1097/01.ccm.0000178186.37167.53. PMID: 16148479.
  62. Marini JJ, Gattinoni L. Propagation prevention: a complementary mechanism for "lung protective" ventilation in acute respiratory distress syndrome. Crit Care Med. 2008 Dec;36(12):3252-8. doi: 10.1097/CCM.0b013e31818f0e68. PMID: 18936705.
  63. Marini JJ. Can we prevent the spread of focal lung inflammation? Crit Care Med. 2010 Oct;38(10 Suppl):S574-81. doi: 10.1097/CCM.0b013e3181f20f01. PMID: 21164400.
  64. Setzer F, Oschatz K, Hueter L, Schmidt B, Schwarzkopf K, Schreiber T. Susceptibility to ventilator induced lung injury is increased in senescent rats. Crit Care. 2013 May 27;17(3):R99. doi: 10.1186/cc12744. PMID: 23710684; PMCID: PMC4056597.
  65. Wunsch H, Linde-Zwirble WT, Angus DC, Hartman ME, Milbrandt EB, Kahn JM. The epidemiology of mechanical ventilation use in the United States. Crit Care Med. 2010 Oct;38(10):1947-53. doi: 10.1097/CCM.0b013e3181ef4460. PMID: 20639743.
Publish with JBRES — Peer-reviewed, multidisciplinary Open Access with rapid review, DOI, and global visibility.
Double-Blind CrossRef DOI Discoverable
Submit Manuscript Membership