Trial reportThe American journal of medicine2017
High Positive End-Expiratory Pressure Is Associated with Improved Survival in Obese Patients with Acute Respiratory Distress Syndrome.
Trial report in The American journal of medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
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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.
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.
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Who cites it
22 citing papers in PubMed, 48 citations in OpenAlex.
- Two Physiologic Latent Classes of Acute Hypoxemic Respiratory Failure in Sepsis Are Distinguished by Lung Mechanics and Gas Exchange.Critical care explorations · 2025Article
- Trajectory-based analysis of early mechanical ventilation PEEP levels and physiological parameter trajectories in ARDS patients and their association with the occurrence of gastrointestinal injury events.BMC pulmonary medicine · 2025Article
- Managing Refractory Hypoxemia in Acute Respiratory Distress Syndrome Obese Patients with Veno-Venous Extra-Corporeal Membrane Oxygenation: A Narrative Review.Journal of clinical medicine · 2025Review
- Patient-Self Inflicted Lung Injury (P-SILI): An Insight into the Pathophysiology of Lung Injury and Management.Journal of clinical medicine · 2025Review
- Gravitational distribution of regional intrapulmonary shunt assessed by EIT in ARDS.Respiratory research · 2025Article
- The Top 100 Cited Articles Focusing on Acute Lung Injury and ARDS: Bibliometric and Visualization Analyses.Respiratory care · 2024Article
- Postoperative hypoxemia for patients undergoing Stanford type A aortic dissection.World journal of clinical cases · 2023Review
- Obesity, malnutrition, and trace element deficiency in the coronavirus disease (COVID-19) pandemic: An overview.Nutrition (Burbank, Los Angeles County, Calif.) · 2021Review
- How to ventilate obese patients in the ICU.Intensive care medicine · 2020Review
- Should patients with obesity be more afraid of COVID-19?Obesity reviews : an official journal of the International Association for the Study of Obesity · 2020Review
- Perspectives on Cardiopulmonary Critical Care for Patients With COVID-19: From Members of the American Heart Association Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation.Journal of the American Heart Association · 2020Article
- The Association Between the Mechanical Ventilator Pressures and Outcomes in a Cohort of Patients with Acute Respiratory Failure.Clinical medicine insights. Circulatory, respiratory and pulmonary medicine · 2020Article
- Association Between Obesity and Short-And Long-Term Mortality in Patients With Acute Respiratory Distress Syndrome Based on the Berlin Definition.Frontiers in endocrinology · 2020Article
- Obesity in the critically ill: a narrative review.Intensive care medicine · 2019Review
- A Comparison of the Effects of Lung Protective Ventilation and Conventional Ventilation on Thermoregulation During Anaesthesia.Turkish journal of anaesthesiology and reanimation · 2019Article
- How I ventilate an obese patient.Critical care (London, England) · 2019Article
- ARDS in Obese Patients: Specificities and Management.Critical care (London, England) · 2019Review
- The effect of obesity on lung function.Expert review of respiratory medicine · 2018Review
- Article
- Pediatric acute respiratory distress syndrome - current views.Experimental and therapeutic medicine · 2018Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundIn acute respiratory distress syndrome, minimizing lung injury from repeated collapse and reopening of alveoli by applying a high positive end-expiratory pressure improves oxygenation without influencing mortality. Obesity causes alveolar atelectasis, thus suggesting that a higher positive end-expiratory pressure might be more protective among the obese. We hypothesized that the effect of applying a high positive end-expiratory pressure on mortality from acute respiratory distress syndrome would differ by obesity status.
methodsThis was a retrospective analysis of 505 patients from the Assessment of Low tidal Volume and elevated End-expiratory volume to Obviate Lung Injury Trial, a multicenter randomized trial that compared a higher vs a lower positive end-expiratory pressure ventilatory strategy in acute respiratory distress syndrome. We examined the relationship between positive end-expiratory pressure strategy and 60-day mortality stratified by obesity status.
resultsAmong obese patients with acute respiratory distress syndrome, those assigned to a high positive end-expiratory pressure strategy experienced lower mortality compared with those assigned to a low strategy (18% vs 32%; P = .04). Among the nonobese, those assigned to high positive end-expiratory pressure strategy experienced similar mortality with those assigned to low strategy (34% vs 23%; P = .13). Multivariate analysis demonstrated an interaction between obesity status and the effect of positive end-expiratory pressure strategy on mortality (P <.01).
conclusionsVentilation with higher levels of positive end-expiratory pressure was associated with improved survival among the subgroup of patients with acute respiratory distress syndrome who are obese.
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