Respiratory failure & ventilation
Effects of aggressive and conservative strategies for mechanical ventilation liberation
Authors' conclusion
Aggressive liberation may improve ventilator free and ICU free days with little impact on mortality in patients with SOFA score < 12.
Study context
- Population
- Mechanically ventilated patients, MIMIC-IV database (version 1.0)
- Participants
- 7,433 participants
- Exposure
- Aggressive vs conservative liberation from lung protective ventilation, relative to usual care
- Outcome
- Time to first liberation attempt
Methodological detailsinverse probability weighting, incremental propensity interventions
- Inverse probability weighting
- Incremental propensity interventions
Main finding
As reported in the abstract
Usual care
43
h
Observational data: associations, not effects.
Further findings
| Outcome | Increase (days) (0.95 CI) | |
|---|---|---|
| ICU-free days, full cohortAggressive vs Usual care | 0.9 ([0.8,1.0]) | |
| Ventilator free days, full cohortAggressive vs Usual care | 0.82 ([0.67,0.97]) | |
| −0.500.511.5Difference, days (linear scale) |
| Outcome | Difference between minimum and maximum rates (0.95 CI) | |
|---|---|---|
| In-hospital mortality, full cohortAggressive vs Usual care · minimal effect on mortality | 0.3% ([−0.2%,0.8%]) | |
| −0.500.51Difference (linear scale) |
| Outcome | Aggressive | Conservative |
|---|---|---|
| In-hospital mortality, baseline SOFA≥ 12 (subgroup, n = 1355) | 58.5% (0.95 CI (55.7%,61.2%)) | 55.1% (0.95 CI (51.6%,58.6%)) |
In-hospital mortality, baseline SOFA≥ 12 (subgroup, n = 1355)
- Aggressive liberation moderately increased mortality vs conservative
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Effects of aggressive and conservative strategies for mechanical ventilation liberation. J Crit Care. Published 14 February 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →