Mean Airway Pressure As a Predictor of 90-Day Mortality in Mechanically Ventilated Patients

Mean Airway Pressure As a Predictor of 90-Day Mortality in Mechanically Ventilated Patients: Objectives:

To determine the association between mean airway pressure and 90-day mortality in patients with acute respiratory failure requiring mechanical ventilation and to compare the predictive ability of mean airway pressure compared with inspiratory plateau pressure and driving pressure.

Design:

Prospective observational cohort.

Setting:

Five ICUs in Lima, Peru.

Subjects:

Adults requiring invasive mechanical ventilation via endotracheal tube for acute respiratory failure.

Interventions:

None.

Measurements and Main Results:

Of potentially eligible participants (n = 1,500), 65 (4%) were missing baseline mean airway pressure, while 352 (23.5%) were missing baseline plateau pressure and driving pressure. Ultimately, 1,429 participants were included in the analysis with an average age of 59 ± 19 years, 45% female, and a mean PaO2/FIO2 ratio of 248 ± 147 mm Hg at baseline. Overall, 90-day mortality was 50.4%. Median baseline mean airway pressure was 13 cm H2O (interquartile range, 10–16 cm H2O) in participants who died compared to a median mean airway pressure of 12 cm H2O (interquartile range, 10–14 cm H2O) in participants who survived greater than 90 days (p