Evidence map›Paper›PMID 26474112›Full record

Observational studyCritical care medicine2016

Timing of Intubation and Clinical Outcomes in Adults With Acute Respiratory Distress Syndrome.

Kirsten Neudoerffer Kangelaris, Lorraine B Ware, Chen Yu Wang, David R Janz, Hanjing Zhuo, Michael A Matthay, Carolyn S Calfee

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Critical care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 122 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
122citing papers in PubMed, 8 pooled it
5.5field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

122 citing papers in PubMed, 8 syntheses or guidelines pooled it, 253 citations in OpenAlex.

  1. Pooled it
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  20. Early enteral nutrition in critically-ill patients.World journal of critical care medicine · 2025
    Review

62 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Kirsten Neudoerffer Kangelaris1Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA.2Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine and Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN.3Department of Critical Care Medicine, Taichung Veteran General Hospital, Taichung, Taiwan.4Section of Pulmonary and Critical Care Medicine, Department of Medicine, Louisiana State University School of Medicine New Orleans, LA.5Division of Pulmonary and Critical Care, University of California, San Francisco, San Francisco, CA.6Departments Medicine and Anesthesia and the Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA.
Lorraine B Ware
Chen Yu Wang
David R Janz
Hanjing Zhuo
Michael A Matthay
Carolyn S Calfee
University of California, San Francisco · USSan Francisco General Hospital · US

Funding

Clinical and Transtional Science InstituteKL2TR000143 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GRANDIS, JENNIFER RUBIN · 2012 to 2015
$11.9M
Clinical and Translational Training Program in Pulmonary MedicineT32HL087738 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Lorraine B Ware · 2007 to 2026
$7.0M
Resolution of Clinical Lung InjuryR37HL051856 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MATTHAY, MICHAEL A. · 2006 to 2015
$3.9M
Cigarette Smoke Exposure and Acute Lung Injury After Severe Blunt TraumaR01HL110969 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CALFEE, CAROLYN · 2012 to 2016
$1.9M
Midcareer Investigator Award in Patient-Oriented Research in Acute Lung InjuryK24HL103836 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI WARE, LORRAINE B · 2010 to 2020
$1.6M
Chemokine-related acute lung injury pathogenesis in African-American patientsK23HL116800 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KANGELARIS, KIRSTEN NEUDOERFFER · 2013 to 2017
$876k
Inflammatory and epithelial injury markers for ARDS prognosis:A validation studyR21HL112656 · NHLBI · VANDERBILT UNIVERSITY · PI WARE, LORRAINE B · 2012 to 2013
$228k
NCATS NIH HHS KL2 TR000143NHLBI NIH HHS K23 HL116800NHLBI NIH HHS K24 HL103836NHLBI NIH HHS R01 HL110969NHLBI NIH HHS R21 HL112656NHLBI NIH HHS R37 HL051856NHLBI NIH HHS T32 HL087738
6 · The paper itself

Abstract

objectiveThe prevalence, clinical characteristics, and outcomes of critically ill, nonintubated patients with evidence of the acute respiratory distress syndrome remain inadequately characterized.

designSecondary analysis of a prospective observational cohort study.

settingVanderbilt University Medical Center. PATIENTS: Among adult patients enrolled in a large, multi-ICU prospective cohort study between the years of 2006 and 2011, we studied intubated and nonintubated patients with acute respiratory distress syndrome as defined by acute hypoxemia (PaO2/FIO2 ≤ 300 or SpO2/FIO2 ≤ 315) and bilateral radiographic opacities not explained by cardiac failure. We excluded patients not committed to full respiratory support.

interventionsNone. MEASUREMENTS AND MAIN

resultsOf 457 patients with acute respiratory distress syndrome, 106 (23%) were not intubated at the time of meeting all other acute respiratory distress syndrome criteria. Nonintubated patients had lower morbidity and severity of illness than intubated patients; however, mortality at 60 days was the same (36%) in both groups (p = 0.91). Of the 106 nonintubated patients, 36 (34%) required intubation within the subsequent 3 days of follow-up; this late-intubation subgroup had significantly higher 60-day mortality (56%) when compared with the both early intubation group (36%, P<0.03) and patients never requiring intubation (26%; p = 0.002). Increased mortality in the late intubation group persisted at 2-year follow-up. Adjustment for baseline clinical and demographic differences did not change the results.

conclusionsA substantial proportion of critically ill adults with acute respiratory distress syndrome were not intubated in their initial days of intensive care, and many were never intubated. Late intubation was associated with increased mortality. Criteria defining the acute respiratory distress syndrome prior to need for positive pressure ventilation are required so that these patients can be enrolled in clinical studies and to facilitate early recognition and treatment of acute respiratory distress syndrome.

Indexed as

FemaleHumansIntubationMaleMiddle AgedProspective StudiesRespiratory Distress SyndromeTime FactorsTreatment Outcome

Identifiers

PMID26474112
PMCPMC4774861
OpenAlexW2325759523

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.