Respiratory failure & ventilation
Association between driving pressure, systemic inflammation and non-pulmonary organ dysfunction in patients with acute respiratory distress syndrome, a prospective pathophysiological study
Authors' conclusion
Driving pressure, but not tidal volume/predicted body weight, was correlated with epithelial and endothelial pulmonary dysfunction, inflammation, coagulation disorders, and hemodynamic dysfunction. However, this relationship diminished over time.
Study context
- Population
- Adults with ARDS on invasive mechanical ventilation, Hospital Clinic of Barcelona, Spain, June 2019–February 2021
- Participants
- 38 adults
- Exposure
- Driving pressure and tidal volume/predicted body weight vs systemic biomarkers and non-pulmonary organ dysfunction
- Outcome
- Association of driving pressure (and tidal volume/predicted body weight) with 22 log-transformed systemic biomarkers (biotrauma) and non-pulmonary multiorgan dysfunction (non-pulmonary SOFA)
- Follow-up
- First, third, and fifth days after study enrollment
Methodological detailssingle-centre, mixed-effects models, mediation analyses
- Single-centre
- Mixed-effects models
- Mediation analyses
Main finding
As reported in the abstract
- Driving pressure independently associated with sRAGE, IL-8, IL-6, IL-10, IL-17, interferon-ɣ, CCL-2, VEGF, tissue factor, protein C, protein S and higher norepinephrine dose
- Association of driving pressure attenuated over time
- Tidal volume/predicted body weight not associated with any of the 22 biomarkers
Observational data: associations, not effects.
Further findings
Mediation analyses
- Concomitant increase in plateau pressure or tidal volume did not mediate the effect of driving pressure on biomarkers
- Association between respiratory system compliance and pulmonary epithelial dysfunction primarily mediated by driving pressure
Original publication
Association between driving pressure, systemic inflammation and non-pulmonary organ dysfunction in patients with acute respiratory distress syndrome, a prospective pathophysiological study. Anaesth Crit Care Pain Med. Published 20 December 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →