Early Changes over Time in the Radiographic Assessment of Lung Edema (RALE) Score are Associated with Survival in Acute Respiratory Distress Syndrome

Autor: Jabaudon, Matthieu, Audard, Jules, Pereira, Bruno, Jaber, Samir, Lefrant, Jean-Yves, Blondonnet, Raiko, Godet, Thomas, Futier, Emmanuel, Lambert, Celine, Bazin, Jean-Etienne, Bastarache, Julie, Constantin, Jean-Michel, Ware, Lorraine, Group, Live Study, Network, Azurea Collaborative
Přispěvatelé: CHU Clermont-Ferrand, Université de Clermont-Ferrand, Unité de Biostatistiques [CHU Clermont-Ferrand], Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), CHU Clermont-Ferrand-CHU Clermont-Ferrand, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Retinoids, Development and Developmental Diseases (R2D2), Université d'Auvergne - Clermont-Ferrand I (UdA), Service d'Anésthésie Réanimation [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], Unité Biostatistique, Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine [Nashville], Génétique, Reproduction et Développement (GReD), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], MORNET, Dominique
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Chest
Chest, American College of Chest Physicians, 2020, ⟨10.1016/j.chest.2020.06.070⟩
Chest, 2020, ⟨10.1016/j.chest.2020.06.070⟩
ISSN: 0012-3692
1931-3543
DOI: 10.1016/j.chest.2020.06.070⟩
Popis: International audience; Background: The Radiographic Assessment of Lung Edema (RALE) score is associated with the severity of ARDS, and treatments targeted at reducing pulmonary edema such as conservative fluid management cause a reduction in RALE score over time.Research question: Are early changes in RALE score over time associated with survival in patients with ARDS?Study design and methods: Data from patients enrolled in three centers in the Lung Imaging for Ventilation sEtting in ARDS (LIVE) trial with available chest radiographs at baseline (day 0) and days 2 or 3 were used. The RALE was scored by two independent reviewers. The primary end point was death by day 90, considering RALE score both at baseline and as a time-varying covariate in a marginal Cox survival model.Results: RALE was scored from 135, 64, and 88 radiographs on days 0, 2, and 3, respectively. Both baseline RALE (hazard ratio [HR] for each one-point increment, 1.04; 95% CI, 1.01-1.08; P = .006) and the change in RALE over time (HR for each one-point decrease per unit of time, 0.99; 95% CI, 0.99-0.99; P = .03) were associated with death by day 90, even after adjustment for age, sex, BMI, Simplified Acute Physiology Score II, vasopressor use, and total volume of fluids received since study entry.Interpretation: The change in RALE during the first days after ARDS onset is independently associated with survival and may be useful as a surrogate end point in future clinical trials of new therapeutics in ARDS.
Databáze: OpenAIRE
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