Elevated Driving Pressure and Elastance Does Not Increase In-Hospital Mortality Among Obese and Severely Obese Patients With Ventilator Dependent Respiratory Failure.
UNLABELLED: Existing recommendations for mechanical ventilation are based on studies that under-sampled or excluded obese and severely obese individuals.
OBJECTIVE: To determine if driving pressure (DP) and total respiratory system elastance (E
DESIGN SETTING AND PARTICIPANTS: Retrospective observational cohort study during 2016-2018 at two tertiary care academic medical centers using electronic health record data from the first 2 full days of mechanical ventilation. The cohort was stratified by BMI classes to measure median DP, time-weighted mean tidal volume, plateau pressure, and E
SETTING AND PARTICIPANTS: Mechanically ventilated patients in medical and surgical ICUs.
MAIN OUTCOMES AND MEASURES: Primary outcome and effect measures included relative risk of in-hospital mortality, ventilator-free days, ICU length of stay, and hospital length of stay with multivariable adjustment.
RESULTS: The cohort included 3,204 patients with 976 (30.4%) and 382 (11.9%) obese and severely obese patients, respectively. Severe obesity was associated with a DP greater than or equal to 15 cm H
CONCLUSIONS AND RELEVANCE: Despite higher DP and E
Published In/Presented At
Terry, C., Brinton, D., Simpson, A. N., Kirchoff, K., Files, D. C., Carter, G., Ford, D. W., & Goodwin, A. J. (2022). Elevated Driving Pressure and Elastance Does Not Increase In-Hospital Mortality Among Obese and Severely Obese Patients With Ventilator Dependent Respiratory Failure. Critical care explorations, 4(12), e0811. https://doi.org/10.1097/CCE.0000000000000811
Medicine and Health Sciences
Department of Medicine