Perioperative medicine & outcomes
Personalized driving pressure-guided positive end-expiratory pressure in patients at risk of postoperative respiratory failure (IMPROVE-2): a multicenter, pragmatic, randomized clinical trial
Authors' conclusion
Among patients at risk for postoperative respiratory failure after emergency abdominal surgery, a strategy of individually adjusted highest PEEP in targeting driving pressure lower than 13 cmH2O did not reduce postoperative respiratory failure or death.
Study context
- Population
- Adults undergoing emergency abdominal surgery at risk for postoperative respiratory failure, 22 hospitals in France
- Participants
- 338 vs 341
- Comparison
- Intervention vs Control
- Interventionn = 338
- Controln = 341reference
- Primary endpoint
- Composite of:
- Postoperative respiratory failure (failure to wean from the ventilator or reintubation or curative NIV)
- All-cause mortality
- Follow-up
- 30 days
Methodological detailsmulticentre, pragmatic, assessor-masked
- Multicentre
- Pragmatic
- Assessor-masked
Primary result
As reported in the abstract
Each group vs controlDifference (95% CI)
Intervention
5.5%(- 0.8 to 11.8)
Each group vs controlRelative risk (95% CI)P value
Intervention
1.27(0.96–1.68)
P = 0.08Secondary outcomes
| Outcome | Difference (95% CI) | |
|---|---|---|
| Reintubation or curative NIVIntervention vs Control | 7.1% (2.5–11.9) | |
| −5051015Difference (linear scale) |
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Reintubation or curative NIVIntervention vs Control | 1.97 (1.24–3.11) | P = 0.004 | |
| 0.20.5125Relative risk (log scale) |
Other secondary outcomes
- Did not differ
Original publication
Personalized driving pressure-guided positive end-expiratory pressure in patients at risk of postoperative respiratory failure (IMPROVE-2): a multicenter, pragmatic, randomized clinical trial. Intensive Care Med. Published 21 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →