{
  "abstract": "Positive end-expiratory pressure (PEEP) can reduce lung collapse, while higher pressures may cause overdistension and unfavorable dead space or pressure effects. The Pediatric Recruitment Engine (PRE) v0.7 is an open-source computational model for supervised teaching about these competing assumptions. It represents 2,560 heterogeneous virtual lung units in 16 conceptual regions. A fixed sequence of increasing and decreasing PEEP updates each unit's probability of remaining open and produces model-derived indices of recruitment, collapse, mechanics, shunt, oxygenation, dead space, carbon dioxide clearance, and regional balance. In one seeded scenario for a 2-year-old, 12-kg child under the moderate impairment preset, several balance and clearance indices selected 16 cmH2O, while the intentionally monotonic oxygenation surrogate selected the upper tested value of 24 cmH2O. Re-running the frozen code reproduced its archived numerical outputs, and 10 scripted execution and expected-behavior checks passed. These checks do not establish independent code verification or physiologic validity. A focused exploratory sensitivity analysis showed that some selected indices changed when illustrative model assumptions were varied. PRE uses no patient-level data, has not been calibrated or externally validated, and cannot recommend patient-specific PEEP. Its code and archived release are publicly available; the full mathematical specification and new exploratory analyses accompany this revision.",
  "abstract_shown": true,
  "affiliations": [
    "General and Pediatric Anesthesia and Intensive Care Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna Policlinico di Sant’Orsola, Bologna, ITA"
  ],
  "article_type": "other",
  "arxiv": null,
  "author_total": 1,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Paolo Taffache"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cmzq7hct8nmb0.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.117389",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13726375/?tool=EBI",
  "id": "cmzq7hct8nmb0",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13726375",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Anesthesiology"
    ],
    [
      "heading",
      "Healthcare Technology"
    ],
    [
      "heading",
      "Medical Education"
    ],
    [
      "openalex",
      "2740|Respiratory Support and Mechanisms"
    ]
  ],
  "openalex": "W7218336823",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13726375/pdf/?tool=EBI",
  "pmcid": "PMC13726375",
  "pmid": "42974440",
  "published": "2026-10-03",
  "publisher": "Cureus Inc.",
  "ris": "https://research.draconitic.com/paper/cmzq7hct8nmb0.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:51Z",
      "native_id": "PMC:PMC13726375",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13726375"
    },
    {
      "first_seen": "2026-11-04T15:20:49Z",
      "native_id": "MED:42974440",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42974440"
    },
    {
      "first_seen": "2026-11-05T12:22:45Z",
      "native_id": "PMC13726375",
      "source": "pmc",
      "url": "https://doi.org/10.7759/cureus.117389"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "heading:Anesthesiology",
      "subfield": "surgery"
    }
  ],
  "title": "The Pediatric Recruitment Engine: A Transparent Computational Model for Inspecting Assumptions During Positive End-Expiratory Pressure Titration",
  "title_text": "The Pediatric Recruitment Engine: A Transparent Computational Model for Inspecting Assumptions During Positive End-Expiratory Pressure Titration",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:22:21Z",
  "url": "https://research.draconitic.com/paper/cmzq7hct8nmb0",
  "venue": "Cureus",
  "versions": []
}