ArticleCritical care explorations2022
Hospital Variation in Management and Outcomes of Acute Respiratory Distress Syndrome Due to COVID-19.
Article in Critical care explorations, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 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.
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Who cites it
10 citing papers in PubMed.
- Prone Positioning in a North American Cohort of Hypoxemic Patients on Mechanical Ventilation.medRxiv : the preprint server for health sciences · 2025Article
- Subphenotyping prone position responders with machine learning.Critical care (London, England) · 2025Observational
- Lung Protective Ventilation Adherence and Outcomes for Patients With COVID-19 Acute Respiratory Distress Syndrome Treated in an Intermediate Care Unit Repurposed to ICU Level of Care.Critical care explorations · 2024Observational
- Observational
- Pneumomediastinum and pneumothorax in acute respiratory distress syndrome (ARDS) patients: a narrative review.Mediastinum (Hong Kong, China) · 2024Review
- Adaptation and Uncertainty: A Qualitative Examination of Provider Experiences With Prone Positioning for Intubated Patients With COVID-19 ARDS.CHEST critical care · 2023Article
- RT education and COVID-19 pneumonia discharge quality.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2023Article
- Factors Influencing the Implementation of Prone Positioning during the COVID-19 Pandemic: A Qualitative Study.Annals of the American Thoracic Society · 2023Article
- SWEAT ICU-An Observational Study of Physician Workload and the Association of Physician Outcomes in Academic ICUs.Critical care explorations · 2022Article
- Comparing Prone Positioning Use in COVID-19 Versus Historic Acute Respiratory Distress Syndrome.Critical care explorations · 2022Article
Corrections and comments
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Authors and funding
17 authors.
Funding
Abstract
objectivesTo describe hospital variation in use of "guideline-based care" for acute respiratory distress syndrome (ARDS) due to COVID-19.
designRetrospective, observational study.
settingThe Society of Critical Care Medicine's Discovery Viral Infection and PATIENTS: Adult patients with ARDS due to COVID-19 between February 15, 2020, and April 12, 2021.
interventionsHospital-level use of "guideline-based care" for ARDS including low-tidal-volume ventilation, plateau pressure less than 30 cm H MEASUREMENTS AND MAIN
resultsAmong 1,495 adults with COVID-19 ARDS receiving care across 42 hospitals, 50.4% ever received care consistent with ARDS clinical practice guidelines. After adjusting for patient demographics and severity of illness, hospital characteristics, and pandemic timing, hospital of admission contributed to 14% of the risk-adjusted variation in "guideline-based care." A patient treated at a randomly selected hospital with higher use of guideline-based care had a median odds ratio of 2.0 (95% CI, 1.1-3.4) for receipt of "guideline-based care" compared with a patient receiving treatment at a randomly selected hospital with low use of recommended therapies. Median-adjusted inhospital mortality was 53% (interquartile range, 47-62%), with a nonsignificantly decreased risk of mortality for patients admitted to hospitals in the highest use "guideline-based care" quartile (49%) compared with the lowest use quartile (60%) (odds ratio, 0.7; 95% CI, 0.3-1.9;
conclusionsDuring the first year of the COVID-19 pandemic, only half of patients received "guideline-based care" for ARDS management, with wide practice variation across hospitals. Strategies that improve adherence to recommended ARDS management strategies are needed.
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