• Kyung Hun Nam, Jason Phua, Bin Du, Shinichiro Ohshimo, Hwa Jung Kim, Chae-Man Lim, Sheila Nainan Myatra, Nik Azman Bin Nik Adib, Yaseen M Arabi, Ming-Cheng Chan, Mohammad Omar Faruq, Ike Sri Redjeki, Do Ngoc Son, Khalid Mahmood Khan Nafees, Dilshan Priyankara, Boonsong Patjanasoontorn, Jose Emmanuel Palo, Aidos Konkayev, Gentle Sunder Shrestha, Younsuck Koh, and IMPROVE Study Investigators, for the Asian Critical Care Clinical Trials Group.
• Department of Critical Care Medicine, Seongnam Citizens Medical Center, Seongnam, South Korea.
• J Crit Care. 2024 Feb 1; 79: 154452154452.

PurposeThis study investigated current practices of mechanical ventilation in Asian intensive care units, focusing on tidal volume, plateau pressure, and positive end-expiratory pressure (PEEP).Materials And MethodsIn this multicenter cross-sectional study, data on mechanical ventilation and clinical outcomes were collected. Predictors of mortality were analyzed by univariate and multivariable logistic regression. A scoring system was generated to predict 28-day mortality.ResultsA total of 1408 patients were enrolled. In 138 patients with acute respiratory distress syndrome (ARDS), 65.9% were on a tidal volume ≤ 8 ml/kg predicted body weight (PBW), and 71.3% were on sufficient PEEP. In 1270 patients without ARDS, 88.8% were on a tidal volume ≤ 10 ml/kg PBW. A plateau pressure < 30 cmH2O was measured in 92.2% of patients. Mortality rates increased from 13% to 74% as the generated predictive score increased from 5 to ≥8.5. Income classification, age, SOFA score, PaO2/FiO2 ratio, plateau pressure, number of vasopressors, and steroid use were associated with mortality.ConclusionsIn Asia, low tidal volume ventilation and sufficient PEEP were underused in patients with ARDS. The majority of patients without ARDS were on intermediate tidal volumes. Country income, age, and severity of illness were associated with mortality.Copyright © 2023 Elsevier Inc. All rights reserved.

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