Respiratory failure & ventilation
PEEP-AKI-COVID intensive care unit (ICU): Effect of positive end-expiratory pressure on acute kidney injury development in patients with COVID-19-associated acute respiratory distress syndrome: an ancillary analysis of the COVID-ICU study
Primary result · AKIResult — go to the resultOdds ratio 1.10 95% CI 1.05–1.16Authors' conclusion
In patients with COVID-19-related ARDS patients, higher PEEP levels within the first 5 days after intubation were independently associated with AKI.
Study context
- Population
- Critically ill patients with COVID-19-related ARDS, mechanically ventilated ≥48 h, normal renal function before intubationfrom 4244 COVID-ICU patients, 149 ICUs
- Participants
- 1,066 patients
- Comparison
- Higher vs lower daily mean positive end-expiratory pressure (PEEP)
- Primary endpoint
- AKI (Kidney Disease Improving Global Outcomes (KDIGO) criteria; KDIGO score > 1)
- Follow-up
- First 5 days after intubation
Methodological detailsancillary analysis, international, multicentre, multivariable logistic regression
- Ancillary analysis
- International
- Multicentre
- Multivariable logistic regression
Primary result
AKI
Odds ratio
1.10
95% CI 1.05–1.16
Higher vs lower daily mean PEEP (continuous variable, averaged over first 3 days of mechanical ventilation)
OR 1.10 (95% CI 1.05–1.16)
As reported in the abstract
- Acute Kidney Injury (AKI) incidence
- 510 (48%)
Original publication
PEEP-AKI-COVID ICU: Effect of positive end-expiratory pressure on acute kidney injury development in patients with COVID-19-associated acute respiratory distress syndrome: an ancillary analysis of the COVID-ICU study. J Intensive Care. Published 30 October 2025. doi:10.
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