Respiratory failure & ventilation
Differential Effect of Positive End-Expiratory Pressure Strategies in Patients With ARDS: A Bayesian Analysis of Clinical Subphenotypes
Authors' conclusion
We found evidence of differential response to PEEP strategies across two ARDS subphenotypes, suggesting possible harm with a higher PEEP strategy in one subphenotype.
Study context
- Population
- Adults with ARDS classified into two subphenotypes (A, B) using nine routinely available clinical variables
- Participants
- 1,559 adults · 2 trials
- Comparison
- Higher vs lower positive end-expiratory pressure (PEEP) strategy, by ARDS subphenotype
- Primary endpoint
- 28-day mortality
- Follow-up
- 28 days
Methodological detailsBayesian hierarchical logistic model, subphenotype analysis
- Bayesian hierarchical logistic model
- Subphenotype analysis
Primary result
As reported in the abstract
28-day mortality by subphenotype
Higher PEEP vs Lower PEEPOdds ratio (95% CrI)
Subphenotype A, ALVEOLI; probability of harm 94.3%
1.61(0.90–2.94)
Subphenotype A, ART; probability of harm 97.7%
1.73(1.01–2.98)
Subphenotype B, ALVEOLI; probability of benefit 56.4%
0.95(0.51–1.73)
Subphenotype B, ART; probability of benefit 50.7%
1.00(0.63–1.55)
Further findings
Effect modification by PaO2/FiO2, driving pressure, severity of illness
- Effects not modified by PaO2/FiO2 ratio, driving pressure, or severity of illness
Original publication
Differential Effect of Positive End-Expiratory Pressure Strategies in Patients With ARDS: A Bayesian Analysis of Clinical Subphenotypes. Chest. Published 18 May 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →