Table 2.
Ventilatory Management and Adjunctive Interventions in Each ARDS Phenotypic Group
| Parameter | H Phenotype (Crs < 40) | Intermediate Phenotype (40 ≤ Crs < 50) | L Phenotype (Crs ≥ 50) | P Value |
|---|---|---|---|---|
| n (%) | 827 (74.04) | 154 (13.79) | 136 (12.18) | — |
| Ventilator settings, first day of ARDS | ||||
| Crs, ml/cm H2O, median (IQR) | 26.25 (21.05–32.00) | 43.27 (41.08–45.45)* | 66.00 (55.00–80.63)*† | <0.0001 |
| Volume Assist-Control mode, n (%) | 276 (33.37) | 69 (44.81)* | 51 (37.50) | 0.0213 |
| FiO2, unit, median (IQR) | 0.60 (0.50–1.00) | 0.60 (0.50–0.80)* | 0.60 (0.40–0.83)* | 0.0026 |
| Set respiratory rate, breaths/min, mean ± SD | 19.87 ± 5.55 | 18.90 ± 5.65 | 17.35 ± 4.49* | <0.0001 |
| Total respiratory rate, breaths/min, mean ± SD | 19.90 ± 5.54 | 18.93 ± 5.66 | 17.43 ± 4.48* | <0.0001 |
| Vt, ml/kg IBW, mean ± SD | 7.50 ± 1.65 | 7.81 ± 1.80 | 8.49 ± 2.15*† | <0.0001 |
| PEEP, cm H2O, mean ± SD | 8.61 ± 3.22 | 8.88 ± 3.55 | 8.35 ± 3.00 | 0.5536 |
| PIP, cm H2O, mean ± SD | 30.31 ± 7.55 | 25.99 ± 6.40* | 22.66 ± 6.77*† | <0.0001 |
| Plateau pressure, cm H2O, mean ± SD | 25.72 ± 5.23 | 19.92 ± 3.62* | 15.90 ± 3.85*† | <0.0001 |
| Driving pressure, cm H2O, mean ± SD | 17.34 ± 4.46 | 11.10 ± 1.90* | 7.64 ± 2.26*† | <0.0001 |
| Standardized Ve, L/min, median (IQR) | 9.64 (7.52–12.78) | 9.73 (8.06–12.56) | 9.90 (8.28–12.89) | 0.2957 |
| Adjunctive measures, first day of ARDS | ||||
| Neuromuscular blockade, n (%) | 158 (19.11) | 22 (14.29) | 15 (11.03)* | 0.0381 |
| Prone positioning, n (%) | 30 (3.63) | 7 (4.55) | 0 (0.00) | 0.0594 |
| Corticosteroids, n (%) | 104 (12.58) | 12 (7.79) | 15 (11.03) | 0.2297 |
| Adjunctive measures, during ICU stay | ||||
| Neuromuscular blockade, n (%) | 236 (28.54) | 36 (23.38) | 21 (15.44)* | 0.0039 |
| Prone positioning, n (%) | 91 (11.00) | 12 (7.79) | 5 (3.68)* | 0.0193 |
| Corticosteroids, n (%) | 169 (20.44) | 23 (14.94) | 23 (16.91) | 0.2154 |
Definition of abbreviations: ARDS = acute respiratory distress syndrome; Crs = respiratory system compliance, ml/cm H2O; H phenotype = phenotype with high elastance or low Crs; IBW = ideal body weight; IQR = interquartile range (first quartile to third quartile); L phenotype = phenotype with low elastance or high Crs; PEEP = positive end-expiratory pressure; PIP = peak inspiratory pressure.
*
P value < 0.05, comparison versus H phenotype (Bonferroni correction).
†
P value < 0.05, comparison versus intermediate phenotype (Bonferroni correction).