Evidence map›Paper›PMID 34909696›Full record

ArticleCritical care explorations2021

Positive End-Expiratory Pressure and Respiratory Rate Modify the Association of Mechanical Power and Driving Pressure With Mortality Among Patients With Acute Respiratory Distress Syndrome.

Joseph E Tonna, Ithan D Peltan, Samuel M Brown, Colin K Grissom, Angela P Presson, Jennifer S Herrick, Francesco Vasques, Heather T Keenan

Abstract read
In one paragraph

Article in Critical care explorations, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

6 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
  4. Observational
  5. Article
  6. The Impact of Mechanical Energy Assessment on Mechanical Ventilation: A Comprehensive Review and Practical Application.Medical science monitor : international medical journal of experimental and clinical research · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Joseph E TonnaDivision of Cardiothoracic Surgery, Department of Surgery, University of Utah Health, Salt Lake City, UT.
Ithan D PeltanDepartment of Pulmonary/Critical Care medicine, Department of Medicine, Intermountain Medical Center, Salt Lake City, UT.
Samuel M BrownDepartment of Pulmonary/Critical Care medicine, Department of Medicine, Intermountain Medical Center, Salt Lake City, UT.
Colin K GrissomDepartment of Pulmonary/Critical Care medicine, Department of Medicine, Intermountain Medical Center, Salt Lake City, UT.
Angela P PressonDivision of Epidemiology, Department of Medicine, University of Utah Health, Salt Lake City, UT.
Jennifer S HerrickDivision of Epidemiology, Department of Medicine, University of Utah Health, Salt Lake City, UT.
Francesco VasquesDepartment of Adult Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
Heather T KeenanDivision of Critical Care, Department of Pediatrics, University of Utah Health, Salt Lake City, UT.

Funding

Utah Center for Clinical and Translational ScienceUL1TR002538 · NCATS · UNIVERSITY OF UTAH · PI HESS, RACHEL, MAJERSIK, JENNIFER JUHL · 2018 to 2022
$26.0M
University of Utah Center for Clinical and Translational ScienceUL1TR001067 · NCATS · UNIVERSITY OF UTAH · PI DERE, WILLARD H., HESS, RACHEL · 2013 to 2017
$19.8M
UNIVERSITY OF UTAH CENTER FOR CLINICAL AND TRANSLATIONAL SCIENCE-UL1: BPCAUL1RR025764 · NCRR · UNIVERSITY OF UTAH · PI MCCLAIN, DONALD A. · 2008 to 2011
$19.4M
University of Utah Center for Clinical and Translational Science-UL1UL1TR000105 · NCATS · UNIVERSITY OF UTAH · PI MCCLAIN, DONALD A. · 2012 to 2013
$5.1M
Long Term Outcomes and Macrophage Biology in Patients with EVALIU01HL123018 · NHLBI · IHC HEALTH SERVICES, INC. · PI BLEDSOE, JOSEPH R, BROWN, SAMUEL MORRIS · 2014 to 2020
$2.4M
Study of Treatment's Echocardiographic Mechanisms (CLOVERS-STEM)R01HL144624 · NHLBI · IHC HEALTH SERVICES, INC. · PI BROWN, SAMUEL MORRIS · 2019 to 2022
$1.8M
Optimizing Selection and Management of Cardiac Arrest Patients Treated with ECMOK23HL141596 · NHLBI · UNIVERSITY OF UTAH · PI TONNA, JOSEPH EDWARD · 2018 to 2022
$945k
Prehospital Activation of ED Teams to Improve Sepsis CareK23GM129661 · NIGMS · IHC HEALTH SERVICES, INC. · PI PELTAN, ITHAN DANIEL · 2019 to 2023
$786k
NCATS NIH HHS UL1 TR000105NCATS NIH HHS UL1 TR001067NCATS NIH HHS UL1 TR002538NCRR NIH HHS UL1 RR025764NHLBI NIH HHS K23 HL141596NHLBI NIH HHS R01 HL144624NHLBI NIH HHS U01 HL123018NIGMS NIH HHS K23 GM129661
6 · The paper itself

Abstract

importanceMechanical power and driving pressure have known associations with survival for patients with acute respiratory distress syndrome.

objectivesTo further understand the relative importance of mechanical power and driving pressure as clinical targets for ventilator management.

designSecondary observational analysis of randomized clinical trial data. SETTING AND

participantsPatients with the acute respiratory distress syndrome from three Acute Respiratory Distress Syndrome Network trials. MAIN OUTCOMES AND MEASURES: After adjusting for patient severity in a multivariate Cox proportional hazards model, we examined the relative association of driving pressure and mechanical power with hospital mortality. Among 2,410 patients, the relationship between driving pressure and mechanical power with mortality was modified by respiratory rate, positive end-expiratory pressure, and flow.

resultsAmong patients with low respiratory rate (< 26), only power was significantly associated with mortality (power [hazard ratio, 1.82; 95% CI, 1.41-2.35; CONCLUSIONS AND RELEVANCE: The relationship between mechanical power and driving pressure with mortality differed within severity subgroups defined by positive end-expiratory pressure, respiratory rate, and airway flow.

Indexed as

acute respiratory distress syndromedriving pressuremechanical powermechanical ventilationventilator-induced lung injury

Identifiers

PMID34909696
PMCPMC8663805

What OpenQuestion holds

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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.