The study evaluated the research development of noninvasive pressure indices for monitoring respiratory effort in mechanical ventilation during 1990–2025 using a bibliometric analysis of the Web of Science and PubMed databases. It included 291 publications from the WOSCC and found an almost U-shaped annual trend, with a decrease after the 1990s and a significant increase after 2011. Most publications came from Italy, followed by the USA and France, with the Institut National de la Sante et de la Recherche Medicale being the most active institution. The journal Chest published the most articles, while the American Journal of Respiratory and Critical Care Medicine had the highest number of citations; the most prolific and influential author was Laurent Brochard. The keywords most frequently pointed to "occlusive pressure" and "mechanical ventilation," and clusters of citations showed major areas of interest such as acute respiratory distress syndrome, self-induced lung injury, and high-flow nasal oxygen therapy. Keyword 'burst' analysis identified new research frontiers: 'respiratory drive', 'lung injury' and 'critically ill patients'. An additional analysis of 242 clinical trials from PubMed confirmed these trends and showed an increasing clinical emphasis on assessing "fluid response" and in patients with amyotrophic lateral sclerosis. The authors conclude that airway pressure indices have moved from purely physiological research to an important clinical tool, with an emphasis on acute respiratory failure, lung protective ventilation, and personalized strategies according to respiratory effort.