Trial reportIntensive care medicine2025
Personalized driving pressure-guided positive end-expiratory pressure in patients at risk of postoperative respiratory failure (IMPROVE-2): a multicenter, pragmatic, randomized clinical trial.
Trial report in Intensive care medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03987789 (Intraoperative Protective Mechanical Ventilation in Patients Requiring Emergency Abdominal Surgery), which is not on this map. Cited by 11 papers.
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.
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.
Intraoperative Protective Mechanical Ventilation in Patients Requiring Emergency Abdominal Surgery: IMPROVE-2 Multicenter Prospective Randomized Trial
Who cites it
11 citing papers in PubMed.
- Effect of PEEP titration on the incidence of elevated driving pressure in laparoscopic bariatric surgery: a randomized superiority trial.BMC anesthesiology · 2026Trial
- Article
- Ventilatory Parameters and Adjunctive Therapies Associated with ICU Mortality in Severe Pneumonia: A Large Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Balancing lung recruitment and venous congestion in ARDS: rethinking the systemic effects of PEEP.Intensive care medicine · 2026Article
- Postoperative ARDS: distinct etiologies, distinct priorities.Intensive care medicine · 2026Article
- Understanding lung physiology through ventilator screen.Intensive care medicine · 2026Article
- Intraoperative Driving Pressure and Postoperative Pulmonary Complications Following Cardiac Surgery: A Prospective Observational Study.Medicina (Kaunas, Lithuania) · 2026Observational
- Is postoperative ARDS different from medical ARDS?Critical care (London, England) · 2026Article
- Driving pressure and postoperative ARDS: an intraoperative silent alarm? Author's reply.Intensive care medicine · 2026Article
- Driving pressure and postoperative ARDS: an intraoperative silent alarm?Intensive care medicine · 2026Article
- Driving pressure as a target for lung protective strategies: from ARDS critically-ill patients to the operating room-Lessons from the IMPROVE-2 Trial.Intensive care medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
Abstract
purposeAirway driving pressure has garnered considerable attention for lung-protective ventilation. We evaluated the clinical effectiveness of airway driving pressure as a target to individualize positive-end-expiratory pressure (PEEP) setting in mechanically ventilated patients at risk for postoperative respiratory failure.
methodsWe conducted a multicenter, pragmatic, assessor-masked, randomized trial among adult patients undergoing emergency abdominal surgery in 22 hospitals in France. Patients were assigned 1:1 to receive individually adjusted highest PEEP targeting a driving pressure < 13 cmH
resultsThe primary outcome occurred in 87 out of 338 (25.7%) intervention patients and in 69 out of 341 (20.2%) control patients (difference, 5.5%; 95% confidence interval [CI] - 0.8 to 11.8; relative risk, 1.27; 95%CI 0.96-1.68; p = 0.08). The difference was primarily due to an increased incidence of reintubation or need for curative non-invasive ventilation among intervention patients (difference, 7.1%; 95% CI 2.5-11.9; relative risk, 1.97; 95% CI 1.24-3.11; p = 0.004). Other secondary outcomes did not differ.
conclusionAmong patients at risk for postoperative respiratory failure after emergency abdominal surgery, a strategy of individually adjusted highest PEEP in targeting driving pressure lower than 13 cmH
trial registrationClinicalTrials.gov Identifier: NCT03987789.
Indexed as
Identifiers
40839096What OpenQuestion holds
Registered trials
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.