Respiratory failure & ventilation
Limiting Dynamic Driving Pressure in Patients Requiring Mechanical Ventilation*
Main finding · Adherence-adjusted mortalityResult — go to the resultRelative risk 0.90 95% CI 0.89–0.92Authors' conclusion
Limiting either static or dynamic ∆P can further reduce the mortality of patients requiring mechanical ventilation.
Study context
- Population
- Adults (≥18 yr) requiring ≥24 hours of mechanical ventilation, 9 ICUs of 7 University of Toronto-affiliated hospitals, April 2014–August 2021
- Participants
- 12,865 eligible patients
- Exposure
- Limiting daily static or dynamic ∆P ≤15 cm H2O vs usual care
- Outcome
- Adherence-adjusted mortality
Methodological detailstarget trial emulation using registry data, emulated pragmatic clinical trials, parametric g-formula, per-protocol effect, multicentre registry
- Target trial emulation using registry data
- Emulated pragmatic clinical trials
- Parametric g-formula
- Per-protocol effect
- Multicentre registry
Main finding
As reported in the abstract
Relative risk
0.90
95% CI 0.89–0.92
By group
Limiting dynamic ∆P vs Usual care
RR 0.90 (95% CI 0.89–0.92)
Observational data: associations, not effects.
Further findings
Timing of intervention
- Effect most pronounced for early and sustained interventions
Limiting static ∆P (static ∆P recorded in 2,473 patients)
- Similar effects observed
Strict interventions on tidal volumes or peak inspiratory pressures, irrespective of ∆P
- Did not reduce mortality vs usual care
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Limiting Dynamic Driving Pressure in Patients Requiring Mechanical Ventilation*. Crit Care Med. Published 27 March 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →