Mechanical ventilation practices in Asian intensive care units: A multicenter cross-sectional study.

Autor: Nam KH; Department of Critical Care Medicine, Seongnam Citizens Medical Center, Seongnam, South Korea., Phua J; FAST and Chronic Programmes, Alexandra Hospital, National University Health System, Singapore; Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, National University Health System, Singapore., Du B; State Key Laboratory of Complex, Severe, and Rare Diseases, Medical ICU, Peking Union Medical College Hospital, Beijing, China., Ohshimo S; Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan., Kim HJ; Department of Clinical Epidemiology and Biostatistics, ASAN Medical Center, University of Ulsan College of Medicine, Seoul, South Korea., Lim CM; Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea., Myatra SN; Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India., Adib NABN; Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia., Arabi YM; King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia., Chan MC; Division of Critical Care and Respiratory Therapy, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; National Chung Hsing University, Taichung, Taiwan., Faruq MO; Critical Care Medicine and Emergency Medicine, United Medical College and United Hospital, Dhaka 1212, Bangladesh., Redjeki IS; Faculty of Medicine, Department of Anesthesiology and Intensive Care, Padjadjaran University, Dr. Hasan Sadikin National Referral Hospital Bandung, Bandung, Indonesia., Son DN; Center for Critical Care Medicine, Bach Mai Hospital, University of Medicine and Pharmacy, Hanoi National University, Viet Nam., Nafees KMK; RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam., Priyankara D; Critical Care Medicine, National Hospital of Sri Lanka, Sri Lanka., Patjanasoontorn B; Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand., Palo JE; Acute and Critical Care Institute, The Medical City, Pasig City, Philippines., Konkayev A; Anaesthesia and ICU Department, Astana Medical University, Institution of Traumatology and Orthopedics, Nur-Sultan, Kazakhstan., Shrestha GS; Department of Critical Care Medicine Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal., Koh Y; Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. Electronic address: yskoh@amc.seoul.kr.
Jazyk: angličtina
Zdroj: Journal of critical care [J Crit Care] 2024 Feb; Vol. 79, pp. 154452. Date of Electronic Publication: 2023 Nov 08.
DOI: 10.1016/j.jcrc.2023.154452
Abstrakt: Purpose: This 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 Methods: In 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.
Results: A 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 cmH 2 O 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, PaO 2 /FiO 2 ratio, plateau pressure, number of vasopressors, and steroid use were associated with mortality.
Conclusions: In 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.
Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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