Rethinking ARDS classification: oxygenation impairment fails to predict VILI risk.

ABSTRACT:

Purpose

The selection and intensity of respiratory support for ARDS are guided by PaO₂/FiO₂. However, ventilator-induced lung injury (VILI) is linked to respiratory mechanics and ventilator settings. We explored whether the VILI risk is related to ARDS severity based on oxygenation.

Methods

We analysed data on 228 ARDS subjects with PaO₂/FiO₂ < 200 mmHg, categorized into three severity groups: one based on PaO₂/FiO₂ ratio, and the others based on tertiles of predictors of VILI: mechanical power ratio (MPR) and driving pressure (DP). In each group of oxygenation-based ARDS severity and MPR and DP tertiles, we measured CT anatomy, gas exchange, respiratory mechanics, VILI prerequisites (lung elastance and lung g

SUBMITTER: Catozzi G 

PROVIDER: S-EPMC11787250 | biostudies-literature | 2025 Jan

REPOSITORIES: biostudies-literature