PONE-D-19-29054

Effect of moderate elevated intra-abdominal pressure on lung mechanics and histological lung injury at different positive end-expiratory pressures

PLOS ONE

Dear Dr. Kalenka,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

The authors are to be commended for the design and reporting of a study relevant to clinical practice in the critically ill patient population.  Although the manuscript is generally well written and well presented, there are several errors of English language usage and a few typographical errors that should be corrected.  These errors were identified during a careful line-by-line review of the manuscript.  The assistance of a copy editor with expertise in English publication may prove useful. 

More significantly, there are several errors in the references.  First, and most importantly, the references are to be cited in order of mention in the manuscript.  For example, the first references mentioned in the manuscript are Reference 5 and Reference 6.  Therefore, Reference 5 should actually be Reference 1.  Accordingly, all of the references will have to be re-ordered and re-numbered.  Additionally, several errors in the formatting of the references must be corrected.  Some of the titles of the references are capitalized when they should be listed in lower case; some of the terminal page numbers are missing; and there are discrepancies of years of publication in a few of the references (two different years of publication listed within the same reference).  The authors are directed to the PLOS ONE submission guidelines with respect to formatting of references:  “Because all references will be linked electronically as much as possible to the papers they cite, proper formatting of the references is crucial.”

A revision that focuses on attention to these details and correction of the errors is required for the manuscript to be considered for publication in PLOS ONE.   

We would appreciate receiving your revised manuscript within 45 days of the date of this letter. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter.

To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). This letter should be uploaded as separate file and labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. This file should be uploaded as separate file and labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. This file should be uploaded as separate file and labeled 'Manuscript'.

Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out.

We look forward to receiving your revised manuscript.

Kind regards,

Linda L. Maerz, MD

Academic Editor

PLOS ONE

Journal Requirements:

When submitting your revision, we need you to address these additional requirements:

1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at http://www.plosone.org/attachments/PLOSOne_formatting_sample_main_body.pdf and http://www.plosone.org/attachments/PLOSOne_formatting_sample_title_authors_affiliations.pdf

2. Please include further information regarding your in vivo study, per our guidelines (http://journals.plos.org/plosone/s/submission-guidelines#loc-animal-research).

Specifically, please provide details regarding:

- The number and type of animals used

- The source of the animals

- Animal health monitoring, including frequency and criteria and any efforts made to reduce suffering and distress, such as administering analgesics

- whether humane endpoints were in place during the study and how they were applied

- the method of anesthesia and euthanasia used

-  any mortality that occurred outside of planned euthanasia or humane endpoints

In addition please complete and submit a copy of the ARRIVE Guidelines checklist, a document that aims to improve experimental reporting and reproducibility of animal studies for purposes of post-publication data analysis and reproducibility: https://www.nc3rs.org.uk/arrive-guidelines. Please include your completed checklist as a Supporting Information file. Note that if your paper is accepted for publication, this checklist will be published as part of your article.

We thank you for your attention to these requests.

3. PLOS requires an ORCID iD for the corresponding author in Editorial Manager on papers submitted after December 6th, 2016. Please ensure that you have an ORCID iD and that it is validated in Editorial Manager. To do this, go to ‘Update my Information’ (in the upper left-hand corner of the main menu), and click on the Fetch/Validate link next to the ORCID field. This will take you to the ORCID site and allow you to create a new iD or authenticate a pre-existing iD in Editorial Manager. Please see the following video for instructions on linking an ORCID iD to your Editorial Manager account: https://www.youtube.com/watch?v=_xcclfuvtxQ

4. Please include your tables as part of your main manuscript and remove the individual files.

Please note that supplementary tables should be uploaded as separate "supporting information" files.

5. Please upload a copy of Figure 5, to which you refer in your text on page 11. If the figure is no longer to be included as part of the submission please remove all reference to it within the text.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Important question to answer and appropriate porcine model. Technically sound with reasonable statistical analysis and available data. It seems as though selection of an intra-abdominal study pressure of 10 mm Hg was thoughtful. Could consider follow up study at pressures of 15 mm Hg and perhaps 20 mm Hg to evaluate optimal PEEP in those instances. Clinical scenarios rarely end at 6 hrs in human subjects and extending IAP and the study for a prolonged period may also reveal a difference in optimal PEEP recommendations for short term vs. long term intubation.

Reviewer #2: This manuscript is a well-written summary and discussion of a well-designed study. It is a small study and an animal study, and so further study will be needed prior to any significant change in practice. However, the basics of the lung mechanics are relevant and have not been well-established in patients with mildly elevated intra-abdominal pressure. Importantly, this is not meant to comment on patients with abdominal compartment syndrome or larger increases in IAP.

I have no specific concerns about the ethics or publication of this study.

I recommend this study for publication.

**********

6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email us at figures@plos.org. Please note that Supporting Information files do not need this step.

PONE-D-19-29054R1

Effect of moderate elevated intra-abdominal pressure on lung mechanics and histological lung injury at different positive end-expiratory pressures

PLOS ONE

Dear Dr. Kalenka,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

The authors are to be commended for beginning to address some of the technical concerns raised regarding their manuscript.  However, some of the English usage and typographical errors persist, and some new errors are identified in the revised manuscript.  For example:

• In the templated abstract (at the very beginning of the submission) formatting irregularities that were not present previously occur with some of the abbreviations.
• Also in the templated abstract, the words “Methods,” “Results,” and “Conclusions” should appear at the beginning of the paragraphs to which they refer.
• Page 5, line 12:Is “0,3 mg/kg” correct, or should it be “0.3” or “0-3” or something else?
• Page 5, line 14:Is “3,6 mg/kg” correct, or should it be something else (similar to the prior item)?
• Page 6, line 1:“hemodynamic” should be “hemodynamically”
• Page 7, line 24: “weighted” should be “weighed”
• Page 8, lines 4-7:The two sentences beginning with “In case of significant results . . . “ are awkwardly worded and difficult to understand.
• Page 9, line 19: “to” should be “from”
• Page 10, line 2:“ration” should be “ratio”
• Page 11, lines 21-24:The two sentences beginning with “The authors argued that. . . “ should be one sentence with a comma after “decreases” in line 23, or should be reworded altogether.
• Page 13, line 3:“exsudate” should be “exudate”
• Page 13, line 4:Use “ALI” instead of “acute lung injury” since the acronym has already been introduced.
• Page 13, line 9:“Alterations” should be “Alteration”
• Page 21, line 9:“hold” should be “held”
• Page 21, line 12:“bodyweight” should be “body weight”
• Figure 1:“FiO2 0,4” should be “FiO2 0.4” if the 0.4 parameter is correct.However, this is contradicted in the manuscript:Page 5, line 20 states “(FiO2) of 0.3”
• Figure 1 legend, last line:“hold” should be “held”

Additionally, new errors are noted in the citing and reporting of the references.  Specifically:

• References 25 and 26 are cited on page 11, line 11.However, there is no antecedent citing of references 22, 23, or 24.Reference 24 is cited out of order (after the aforementioned citing of References 25 and 26).Reference 22 and Reference 23 are not cited at all.
• The last reference cited in the manuscript is Reference 30.However, 33 references are listed at the end of the manuscript.
• The authors did not provide tracked changes for their revisions to the list of references at the end of the manuscript.
• Reference 5:The acronym “acs” should be “ACS”
• Reference 21:“american thoracic society” should be “American Thoracic Society”
• Reference 27:The title of the manuscript should be lower case.

The above notations are examples of errors.  Again, the assistance of a copy editor with expertise in English publication may prove useful.  An additional revision that focuses attention on correction of these and any additional errors is required for the manuscript to be considered for publication in PLOS ONE.  Of note, the errors in reference order and citation are particularly important.

We would appreciate receiving your revised manuscript by 45 days from the date of this letter. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter.

To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). This letter should be uploaded as separate file and labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. This file should be uploaded as separate file and labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. This file should be uploaded as separate file and labeled 'Manuscript'.

Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out.

We look forward to receiving your revised manuscript.

Kind regards,

Linda L. Maerz, MD

Academic Editor

PLOS ONE

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email us at figures@plos.org. Please note that Supporting Information files do not need this step.

PONE-D-19-29054R2

Effect of moderate elevated intra-abdominal pressure on lung mechanics and histological lung injury at different positive end-expiratory pressures

Dear Dr. Kalenka, 

Thank you for submitting your revised manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to again submit a revised version of the manuscript that addresses the points raised during the review process.

The authors are to be commended for addressing the majority of the requested revisions.  In particular, the re-numbering of the references is appreciated.  However, a few items remain to be addressed:

• In the templated abstract (at the very beginning of the submission) formatting irregularities that were not present in the original submission occur with some of the abbreviations.  Specifically, this pertains to the abbreviations H2O, Cstat, and ΔPL.
• Figure 1:  "FiO2 0,4" should be "FiO2 0.4"
• Figure 1 legend, last line: “hold” should be “held”
• Reference 27:The title of the manuscript should be lower case.

The authors’ attention to these remaining details will be appreciated.

==============================

We would appreciate receiving your revised manuscript within 45 days of the date of this letter. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter.

To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). This letter should be uploaded as separate file and labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. This file should be uploaded as separate file and labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. This file should be uploaded as separate file and labeled 'Manuscript'.

Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out.

We look forward to receiving your revised manuscript.

Kind regards,

Linda L. Maerz, MD

Academic Editor

PLOS ONE

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email us at figures@plos.org. Please note that Supporting Information files do not need this step.

Effect of moderate elevated intra-abdominal pressure on lung mechanics and histological lung injury at different positive end-expiratory pressures

PONE-D-19-29054R3

Dear Dr. Kalenka,

We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements.

Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication.

Shortly after the formal acceptance letter is sent, an invoice for payment will follow. To ensure an efficient production and billing process, please log into Editorial Manager at https://www.editorialmanager.com/pone/, click the "Update My Information" link at the top of the page, and update your user information. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org.

If your institution or institutions have a press office, please notify them about your upcoming paper to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, you must inform our press team as soon as possible and no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

With kind regards,

Linda L. Maerz, MD

Academic Editor

PLOS ONE