{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T20:21:27Z","timestamp":1788898887189,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate dynamic parameter changes within 72\u2009h of intensive care unit (ICU) admission for predicting extubation failure and 28\u2010day mortality in patients with severe pneumonia\u2010induced acute respiratory distress syndrome (ARDS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study enrolled 424 adults with severe pneumonia\u2010induced ARDS receiving invasive ventilation \u2265\u200948\u2009h during January 2023\u2013August 2025. We collected clinical data and calculated 72\u2010h changes (\u0394) in key parameters: physiological stress [maximum respiratory rate (RR), mean heart rate (HR)] and disease progression [\u0394PaO\n                      <jats:sub>2<\/jats:sub>\n                      \/FiO\n                      <jats:sub>2<\/jats:sub>\n                      , \u0394 blood lactate (BLA), \u0394 procalcitonin (PCT), \u0394 Sequential Organ Failure Assessment (SOFA)]. Outcomes were extubation failure (first spontaneous breathing trial failure or reintubation \u2264\u200948\u2009h) and 28\u2010day mortality. Multivariable logistic and Cox regression models were built, with discrimination assessed by ROC curves.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Extubation failure and 28\u2010day mortality rates were 23.82% (101\/424) and 29.48% (125\/424), respectively. For extubation failure, independent risk factors included older age, higher APACHE II score at admission, immunosuppression, higher maximum RR, higher mean HR, and increased \u0394BLA, \u0394PCT, and \u0394SOFA (protective factor: increased \u0394PaO\n                      <jats:sub>2<\/jats:sub>\n                      \/FiO\n                      <jats:sub>2<\/jats:sub>\n                      ) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). The prediction model had an AUC of 0.912 (95% CI, 0.883\u20130.941). For 28\u2010day mortality, independent risk factors were higher APACHE II score at admission, higher maximum RR, increased \u0394BLA, and increased \u0394SOFA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), with a time\u2010dependent AUC of 0.755 (95% CI, 0.729\u20130.781). A significant association was observed between extubation failure and 28\u2010day mortality, with a markedly higher mortality rate in patients with extubation failure compared to those with successful extubation (81.19% vs. 13.31%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Dynamic parameters within 72\u2009h of ICU admission are predictors of extubation failure and 28\u2010day mortality in severe pneumonia\u2010induced ARDS, offering a tool for early risk stratification. Extubation failure was also strongly associated with increased short\u2010term mortality, underscoring its clinical significance as an adverse outcome during the disease course.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/crj.70189","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T03:36:54Z","timestamp":1777001814000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Dynamic Parameters within the First 72\u2009H of ICU Admission Predict Extubation Failure and 28\u2010Day Mortality in Severe Pneumonia\u2010Induced ARDS: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"20","author":[{"given":"Chen","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Changzheng Hospital Naval Medical University  Shanghai 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