Different ventilation intensities among various categories of patients ventilated for reasons other than ARDS––A pooled analysis of 4 observational studies

Purpose: We investigated driving pressure (Delta P) and mechanical power (MP) and associations with clinical outcomes in critically ill patients ventilated for reasons other than ARDS. Materials and methods: Individual patient data analysis of a pooled database that included patients from four observational studies of ventilation. Delta P and MP were compared among invasively ventilated non-ARDS patients with sepsis, with pneumonia, and not having sepsis or pneumonia. The primary endpoint was Delta P; secondary endpoints included MP, ICU mortality and length of stay, and duration of ventilation. Results: This analysis included 372 (11%) sepsis patients, 944 (28%) pneumonia patients, and 2040 (61%) patients ventilated for any other reason. On day 1, median Delta P was higher in sepsis (14 [11-18] cmH(2)O) and pneumonia patients (14 [11-18]cmH(2)O), as compared to patients not having sepsis or pneumonia (13 [10-16] cmH(2)O) (P < 0.001). Median MP was also higher in sepsis and pneumonia patients. Delta P, as opposed to MP, was associated with ICU mortality in sepsis and pneumonia patients. Conclusions: The intensity of ventilation differed between patients with sepsis or pneumonia and patients receiving ventilation for any other reason; Delta P was associated with higher mortality in sepsis and pneumonia patients.