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LUNG SAFE: Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE

LUNG SAFE (Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE) is a multicentre, prospective, observational, 4-week inception cohort study, which has been carried out by the Acute Respiratory Failure section through the ESICM Trials Group. The study aimed to prospectively assess the burden of, management and therapeutic approaches to, and outcomes from acute hypoxaemic respiratory failure requiring ventilatory support, with a specific focus on ARDS as defined by the Berlin Definition.

LUNG SAFE Update (13/03/2017)

Publications from the LUNG SAFE study:

Bellani et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA. February 23, 2016, Vol 315, No. 8.

Laffey et al, LUNG SAFE Investigators and the ESICM Trials Group. Potentially modifiable factors contributing to outcome from acute respiratory distress syndrome: the LUNG SAFE study. Intensive Care Med. 2016 Dec;42(12):1865-1876. Epub 2016 Oct 18.

Bellani et al, LUNG SAFE Investigators and the ESICM Trials Group. Noninvasive Ventilation of Patients with Acute Respiratory Distress Syndrome. Insights from the LUNG SAFE Study. AJRCCM; Vol. 195, No. 1 | Jan 01, 2017 DOI: http://dx.doi.org/10.1164/rccm.201606-1306OC

A fourth paper, which is examining the patient group with Acute Hypoxemic Respiratory Failure (non-ARDS) is in progress. A fifth paper, examining the geographic variations in ARDS demographics, management and outcome, is also well advanced.

List of approved OPEN LUNG SAFE Projects

  1. Analysis of patient with ARDS of unknown etiology: Results of the ASTEROID Study [SUB-STUDY]
  2. Impact of a teaching program in increasing accuracy of chest X-ray diagnosis: the Randomised Education in ARDS Diagnosis Study (READ) study
  3. The characteristics of prolonged ventilation in patients with acute respiratory failure
  4. Management and outcome of Acute respiratory failure in immunocompromised patients and in patients with active onco-hematological malignancies
  5. Assessing the effect of diabetes in ARDS or AHRF
  6. Early tracheostomy versus late tracheostomy among mechanically ventilated patients with severe ARDS
  7. End of life care decisions for the patient with severe respiratory failure in ICU
  8. Factors influencing severity of hypoxemia and associated mortality in Severe Acute Hypoxemic Respiratory Failure
  9. How patients with ARDS are weaned from PEEP
  10. Hyperoxia, oxygenation levels and targets in Patients with Acute Hypoxic Respiratory Failure
  11. Impact of spontaneous breathing in early ARDS
  12. Prone position in ARDS in Lung Safe
  13. Risk factors for progression from MILD to more severe ARDS
  14. The influence of obesity in patients with ARDS or AHRF
  15. Structure of ICU and risk standardised mortality ratio in acute hypoxemic respiratory failure
  16. Role of ECMO in LUNG SAFE database
  17. Changes over time in response to therapeutic maneuvers



Recognition and treatment of ARDS: The LUNG SAFE Study


John Laffey & Giacomo Bellani (23/02/16) ~ icTV interview on study findings

John Laffey & Giacomo Bellani (19/12/15) ~ icTV Update with PIs John Laffey and Giacomo Bellani 

John Laffey ~ icTV interview – LUNG SAFEOct 2013 icTV Update

Luciano Gattinoni ~ icTV interview – Utilising the ARDS Definition



OPEN LUNG SAFE Data Access, Publication and Authorship Policy


For more information, please contact LUNG-SAFE@esicm.org