High Positive End-Expiratory Pressure Is Associated with Improved Survival in Obese Patients with Acute Respiratory Distress Syndrome Christian Bime,

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Presentation transcript:

High Positive End-Expiratory Pressure Is Associated with Improved Survival in Obese Patients with Acute Respiratory Distress Syndrome Christian Bime, MD, MSc, Mallorie Fiero, PhD, Zhenqiang Lu, PhD, Eyal Oren, PhD, MS, Cristine E. Berry, MD, MHS, Sairam Parthasarathy, MD, Joe G.N. Garcia, MD The American Journal of Medicine Volume 130, Issue 2, Pages 207-213 (February 2017) DOI: 10.1016/j.amjmed.2016.09.029 Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 1 Average positive end-expiratory pressure levels by group assignment during the first 28 days of the study. The American Journal of Medicine 2017 130, 207-213DOI: (10.1016/j.amjmed.2016.09.029) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 2 Obese vs nonobese – odds ratio of mortality, barotrauma, and unassisted breathing by day 28 for high PEEP group: All study patients, Obese (BMI ≥30 kg/m2), and Nonobese (BMI <30 kg/m2). BMI = body mass index; PEEP = positive end-expiratory pressure. The American Journal of Medicine 2017 130, 207-213DOI: (10.1016/j.amjmed.2016.09.029) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 3 Results of logistic regression models of each outcome (60-day mortality, unassisted breathing by day 28, barotrauma) with BMI and positive end-expiratory pressure group (high vs low) as the predictive variables. (A) Predicted 60-day mortality (95% CI) was computed using logistic regression model with positive end-expiratory pressure, BMI, and interaction terms as predictor variables. (B) Predicted rate of unassisted breathing (95% CI) was computed using logistic regression model with positive end-expiratory pressure, BMI, and interaction terms as predictor variables. (C) Predicted barotrauma rate (95% CI) was computed using logistic regression model with positive end-expiratory pressure, BMI, and interaction terms as predictor variables. BMI = body mass index; CI = confidence interval; PEEP = positive end-expiratory pressure; UAB = unassisted breathing. The American Journal of Medicine 2017 130, 207-213DOI: (10.1016/j.amjmed.2016.09.029) Copyright © 2016 Elsevier Inc. Terms and Conditions