Driving pressure-guided ventilation versus protective lung ventilation in ARDS patients: A prospective randomized controlled study

Hamama, Khaled M.; Fathy, Sameh M.; AbdAlrahman, Reda S.; Alsherif, Salah El-Din I.; Ahmed, Sameh Abdelkhalik

doi:TEJA-2021-0047

Driving pressure-guided ventilation versus protective lung ventilation in ARDS patients: A prospective randomized controlled study

Authors

TEJA-2021-0047

Abstract

: Secondary analyses of randomized controlled trials found that driving pressure (DP) ≤ 14 cm HO may be associated with improved clinical outcomes in acute respiratory distress syndrome (ARDS) patients. Therefore, the aim of this study was to evaluate the effect of DP-guided ventilation compared to conventional protective lung ventilation (PLV) on clinical outcomes in ARDS patients.
: In this prospective, controlled trial, 110 patients with ARDS were randomly assigned according to ventilatory strategy into conventional PLV group and DP-guided ventilation group (by maintaining DP value ≤ 14 cm HO). Clinical outcomes were incidence of mortality at 28 day (primary outcome), PaO/FiO, static compliance (C), organ(s) dysfunction, mechanical ventilation (MV) duration, and length of ICU stay.
: Incidence of mortality at 28 day was reduced in DP-guided ventilation group compared to PLV group (20% vs. 5.45%); the hazard ratio was 0.26)95% CI: 0.09 to 0.73). The PaO/FiO, C and MV-free days were higher in in DP-guided ventilation group compared to PLV group. Organ dysfunction, duration of MV and length of ICU stay were significantly lower DP-guided ventilation group compared to PLV group.
: In patients with ARDS, DP-guided ventilation showed improved survival, C and oxygenation and lower incidence of organ dysfunction, duration of MV and length of ICU stay compared to PLV.

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