ArticleCritical care medicine2017
A Quantile Analysis of Plateau and Driving Pressures: Effects on Mortality in Patients With Acute Respiratory Distress Syndrome Receiving Lung-Protective Ventilation.
Article in Critical care medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07328997 (Exploration of Diagnosis and Treatment Strategies and Prognostic Prediction Models for Acute Respiratory Distress Syndrome Based on Radiographic Evaluations Assessed by Artificial Intelligence), which is not on this map. Cited by 55 papers.
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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.
Exploration of Diagnosis and Treatment Strategies and Prognostic Prediction Models for Acute Respiratory Distress Syndrome Based on Radiographic Evaluations Assessed by Artificial Intelligence
Who cites it
55 citing papers in PubMed.
- The impact of PEEP-guided electrical impedance tomography on oxygenation and respiratory mechanics in moderate-to-severe ARDS: a randomized controlled trial.Scientific reports · 2025Trial
- Effect of a driving pressure-limiting strategy for patients with acute respiratory distress syndrome secondary to community-acquired pneumonia: the STAMINA randomised clinical trial.British journal of anaesthesia · 2025Trial
- Trial
- Pulmonary Mechanics and Mortality in Mechanically Ventilated Patients Without Acute Respiratory Distress Syndrome: A Cohort Study.Shock (Augusta, Ga.) · 2018Trial
- Driving pressure guided ventilation in robot-assisted laparoscopic surgery with steep Trendelenburg position: a randomized controlled study.Anesthesia and pain medicine · 2026Article
- Short-Term Physiological Effects of Moderate PEEP Levels in Invasively Ventilated Patients Without Acute or Chronic Lung Disease.Medical sciences (Basel, Switzerland) · 2026Article
- Correlation of mechanical power and outcome in critically ill patients in Indian population: A prospective observational study.Indian journal of anaesthesia · 2026Article
- A narrative review on the future of ARDS: evolving definitions, pathophysiology, and tailored management.Critical care (London, England) · 2025Review
- Article
- Comparing the impact of targeting limited driving pressure to low tidal volume ventilation on mortality in mechanically ventilated adults with COVID-19 ARDS: an exploratory target trial emulation.BMJ open respiratory research · 2024Article
- Lower Late Development Rate of Acute Respiratory Distress Syndrome in Patients with Lower Mechanical Power or Driving Pressure.Diagnostics (Basel, Switzerland) · 2024Article
- Early identification and diagnosis, pathophysiology, and treatment of sepsis-related acute lung injury: a narrative review.Journal of thoracic disease · 2024Review
- Driving pressure in mechanical ventilation: A review.World journal of critical care medicine · 2024Review
- Predictive performance of the variation rate of the driving pressure on the outcome of invasive mechanical ventilation in patients with acute respiratory distress syndrome.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2024Article
- Driving pressure, as opposed to tidal volume based on predicted body weight, is associated with mortality: results from a prospective cohort of COVID-19 acute respiratory distress syndrome patients.Critical care science · 2024Observational
- Role of Changes in Driving Pressure and Mechanical Power in Predicting Mortality in Patients with Acute Respiratory Distress Syndrome.Diagnostics (Basel, Switzerland) · 2023Article
- Challenges in ARDS Definition, Management, and Identification of Effective Personalized Therapies.Journal of clinical medicine · 2023Review
- Clinical relevance of timing of assessment of ICU mortality in patients with moderate-to-severe Acute Respiratory Distress Syndrome.Scientific reports · 2023Article
- ARDS Clinical Practice Guideline 2021.Journal of intensive care · 2022Article
- Driving pressure-guided ventilation decreases the mechanical power compared to predicted body weight-guided ventilation in the Acute Respiratory Distress Syndrome.Critical care (London, England) · 2022Article
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Authors and funding
24 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe driving pressure (plateau pressure minus positive end-expiratory pressure) has been suggested as the major determinant for the beneficial effects of lung-protective ventilation. We tested whether driving pressure was superior to the variables that define it in predicting outcome in patients with acute respiratory distress syndrome.
designA secondary analysis of existing data from previously reported observational studies.
settingA network of ICUs. PATIENTS: We studied 778 patients with moderate to severe acute respiratory distress syndrome.
interventionsNone. MEASUREMENTS AND MAIN
resultsWe assessed the risk of hospital death based on quantiles of tidal volume, positive end-expiratory pressure, plateau pressure, and driving pressure evaluated at 24 hours after acute respiratory distress syndrome diagnosis while ventilated with standardized lung-protective ventilation. We derived our model using individual data from 478 acute respiratory distress syndrome patients and assessed its replicability in a separate cohort of 300 acute respiratory distress syndrome patients. Tidal volume and positive end-expiratory pressure had no impact on mortality. We identified a plateau pressure cut-off value of 29 cm H2O, above which an ordinal increment was accompanied by an increment of risk of death. We identified a driving pressure cut-off value of 19 cm H2O where an ordinal increment was accompanied by an increment of risk of death. When we cross tabulated patients with plateau pressure less than 30 and plateau pressure greater than or equal to 30 with those with driving pressure less than 19 and driving pressure greater than or equal to 19, plateau pressure provided a slightly better prediction of outcome than driving pressure in both the derivation and validation cohorts (p < 0.0000001).
conclusionsPlateau pressure was slightly better than driving pressure in predicting hospital death in patients managed with lung-protective ventilation evaluated on standardized ventilator settings 24 hours after acute respiratory distress syndrome onset.
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