# Driving Pressure as a Target for Lung-Protective Ventilation

> **NIH NIH K23** · JOHNS HOPKINS UNIVERSITY · 2022 · $177,024

## Abstract

PROJECT SUMMARY/ABSTRACT
Sarina Sahetya, MD MHS is a pulmonary and critical care physician-scientist at Johns Hopkins University, with
a Master’s degree in Clinical Investigation. This K23 proposal will provide her valuable training towards her
long-term career goal of being an independent, NIH-funded, patient-oriented investigator conducting
randomized trials to improve clinical outcomes for patients with acute respiratory failure. Acute respiratory
distress syndrome (ARDS) is a common and frequently fatal type of acute respiratory failure with an overall
mortality ~40%. Mechanical ventilation is a cornerstone of ARDS management. Despite its life-saving effect,
mechanical ventilation also can cause ventilator-induced lung injury (VILI), which can increase morbidity and
mortality. Recently, the COVID-19 pandemic has highlighted the importance of optimal lung-protective
ventilation strategies to improve patient outcomes. Recent observational studies suggest that targeting low
Driving Pressure, as part of a mechanical ventilation approach for ARDS, could improve mortality. This K23
grant builds on Dr. Sahetya’s prior experience with developing physiologically-guided mechanical ventilation
approaches for reducing Driving Pressure. In this K23, she will prospectively evaluate a Driving Pressure-
guided approach to lung-protective ventilation. The research will be completed within the highly supportive
training environment at Johns Hopkins, with the guidance of a team of superb mentors with relevant expertise.
The overall objectives of this K23 Award are to: (1) complete rigorous multi-phase pilot work evaluating a lung-
protective ventilation strategy minimizing Driving Pressure for ARDS patients, and (2) develop essential skills
for the candidate to be a successful independent patient-oriented investigator. The career development plan
combines didactics, with outstanding mentorship in key areas of advanced statistical analysis, rigorous
protocol and trial design optimization via qualitative methods, and conduct of a pilot randomized trial, to ensure
a successful transition to independence. Using a large database of ARDS patients enrolled in a recent NHLBI-
funded trial, Dr. Sahetya will evaluate the relationship between changes in Driving Pressure, arising from
changes in positive end-expiratory pressure, and mortality as well as explore patient characteristics that modify
this relationship (Aim 1). She will use qualitative methods to gain in-depth understanding of clinicians’
perspectives on optimizing the design of ventilation RCTs in order to refine a proposed Driving Pressure-
guided pilot trial (Aim 2). Finally, she will conduct a pilot randomized controlled trial evaluating the feasibility of
a Driving Pressure-guided ventilation strategy compared to the ARDS Network lung-protective ventilation
protocol (Aim 3). This rigorous training and mentored research experience will foster continued productivity,
provide preliminary data for a future NIH...

## Key facts

- **NIH application ID:** 10474469
- **Project number:** 5K23HL155507-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Sarina Sahetya
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $177,024
- **Award type:** 5
- **Project period:** 2021-09-01 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10474469

## Citation

> US National Institutes of Health, RePORTER application 10474469, Driving Pressure as a Target for Lung-Protective Ventilation (5K23HL155507-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10474469. Licensed CC0.

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