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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Driving pressure is a risk factor for ards in mechanically ventilated subjects without ards
Respiratory Care, Volume 66, No. 10, Year 2021
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Description
BACKGROUND: Driving pressure (DP) has been described as a risk factor for mortality in patients with ARDS. However, the role of DP in the outcome of patients without ARDS and on mechanical ventilation has received less attention. Our objective was to evaluate the association between DP on the first day of mechanical ventilation with the development of ARDS. METHODS: This was a post hoc analysis of a multicenter, prospective, observational, international study that included subjects who were on mechanical ventilation for>12 h. Our objective was to evaluate the association between DP on the first day of mechanical ventilation with the development of ARDS. To assess the effect of DP, a logistic regression analysis was performed when adjusting for other potential risk factors. Validation of the results obtained was performed by using a bootstrap method and by repeating the same analyses at day 2. RESULTS: A total of 1,575 subjects were included, of whom 65 (4.1%) developed ARDS. The DP was independently associated with ARDS (odds ratio [OR] 1.12, 95% CI 1.07-1.18 for each cm H2O of DP increase, P<.001). The same results were observed at day 2 (OR 1.14, 95% CI 1.07-1.21; P<.001) and after bootstrap validation (OR 1.13, 95% CI 1.04-1.22; P<.001). When taking the prevalence of ARDS in the lowest quartile of DP (^9 cm H2O) as a reference, the subjects with DP>12-15 cm H2O and those with DP>15 cm H2O presented a higher probability of ARDS (OR 3.65, 95% CI 1.32-10.04 [P 5.01] and OR 7.31, 95% CI, 2.89-18.50 [P<.001], respectively). CONCLUSIONS: In the subjects without ARDS, a higher level of DP on the first day of mechanical ventilation was associated with later development of ARDS. (ClinicalTrials.gov registration NCT02731898.). © 2021 Daedalus Enterprises.
Authors & Co-Authors
Roca, F.
Unknown Affiliation
Peñuelas, Óscar
Unknown Affiliation
Muriel, A.
Unknown Affiliation
Garciá-De-Acilu, Marina
Unknown Affiliation
Riera, Jordi I.
Unknown Affiliation
Raymondos, Konstantinos
Unknown Affiliation
Du, Bin
Unknown Affiliation
Thille, Arnaud W.
Unknown Affiliation
Ríos, Fernando Gonçalves
Unknown Affiliation
González, Marco A.
Unknown Affiliation
Del-Sorbo, Lorenzo D.
Unknown Affiliation
del Carmen Marín, María
Unknown Affiliation
Soares, Marco Antonio
Unknown Affiliation
Valle Pinheiro, Bruno
Unknown Affiliation
Nín, Nicholas
Unknown Affiliation
Maggiore, Salvatore Maurizio
Unknown Affiliation
Bersten, Andrew D.
Unknown Affiliation
Amin, Pravin R.
Unknown Affiliation
Çakar, Nahit
Unknown Affiliation
Suh, Gee-young
Unknown Affiliation
Jibaja, Manuel
Unknown Affiliation
Matamis, Dimitrios
Unknown Affiliation
Zeggwagh, Amine Ali
Unknown Affiliation
Sutherasan, Yuda
Unknown Affiliation
Anzueto, Antonio R.
Unknown Affiliation
Esteban, Andrés
Unknown Affiliation
Frutos-Vivar, Fernando
Unknown Affiliation
Statistics
Citations: 5
Authors: 27
Identifiers
Doi:
10.4187/respcare.08587
ISSN:
00201324
Study Design
Cross Sectional Study
Cohort Study
Case-Control Study
Study Approach
Quantitative