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Driving pressure is not associated with mortality in mechanically ventilated patients without ARDS.


ABSTRACT: BACKGROUND:In patients with acute respiratory distress syndrome (ARDS), low tidal volume ventilation has been associated with reduced mortality. Driving pressure (tidal volume normalized to respiratory system compliance) may be an even stronger predictor of ARDS survival than tidal volume. We sought to study whether these associations hold true in acute respiratory failure patients without ARDS. METHODS:This is a retrospectively cohort analysis of mechanically ventilated adult patients admitted to ICUs from 12 hospitals over 2 years. We used natural language processing of chest radiograph reports and data from the electronic medical record to identify patients who had ARDS. We used multivariable logistic regression and generalized linear models to estimate associations between tidal volume, driving pressure, and respiratory system compliance with adjusted 30-day mortality using covariates of Acute Physiology Score (APS), Charlson Comorbidity Index (CCI), age, and PaO2/FiO2 ratio. RESULTS:We studied 2641 patients; 48% had ARDS (n?=?1273). Patients with ARDS had higher mean APS (25 vs. 23, p?

SUBMITTER: Lanspa MJ 

PROVIDER: S-EPMC6935179 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Driving pressure is not associated with mortality in mechanically ventilated patients without ARDS.

Lanspa Michael J MJ   Peltan Ithan D ID   Jacobs Jason R JR   Sorensen Jeffrey S JS   Carpenter Lori L   Ferraro Jeffrey P JP   Brown Samuel M SM   Berry Jay G JG   Srivastava Raj R   Grissom Colin K CK  

Critical care (London, England) 20191227 1


<h4>Background</h4>In patients with acute respiratory distress syndrome (ARDS), low tidal volume ventilation has been associated with reduced mortality. Driving pressure (tidal volume normalized to respiratory system compliance) may be an even stronger predictor of ARDS survival than tidal volume. We sought to study whether these associations hold true in acute respiratory failure patients without ARDS.<h4>Methods</h4>This is a retrospectively cohort analysis of mechanically ventilated adult pat  ...[more]

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