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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 1 breath/min. TMV% was measured on the first two days of mechanical ventilation.A total of 337 patients (age: 70 ± 16 years) 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.Our study showed a new clinical parameter, Transitional Minute Volume %, TMV%.TMV%, obtained at the early stage of acute respiratory failure may be an independent prognosticating factor for mortality and wean outcomes.An increase, or lack of decrease, of TMV% from day 1 to day 2 was associated with higher risk of in-hospital death.