Temporal changes in the epidemiology, management, and outcome from acute respiratory distress syndrome in European intensive care units: a comparison of two large cohorts

Autor: David Brealey, Marco Maggiorini, Yannick Malledant, Jan Malaska, Gabriela Droc, Manu Malbrain, Didier Payen, Herbert Spapen, Xavier Wittebole, Marc Leone, Giuseppe Citerio, Angel Estella, Alain LEPAPE, Prof. Katarzyna Laura Kotfis, Pasquale De Negri, Morten Bestle, Artigas Antonio, Ewa Trejnowska, Walter Swinnen, Ricard Ferrer
Přispěvatelé: UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service de soins intensifs, UCL - (MGD) Services des soins intensifs, Supporting clinical sciences, Intensive Care, Internal Medicine Specializations, Sakr, Y, Francois, B, Sole-Violan, J, Kotfis, K, Jaschinski, U, Estella, A, Leone, M, Jakob, S, Wittebole, X, Fontes, L, de Melo Gurgel, M, Midega, T, Vincent, J, Ranieri, V, Citerio, G, Sakr, Yasser, François, Bruno, Solé-Violan, Jordi, Kotfis, Katarzyna, Jaschinski, Ulrich, Estella, Angel, Leone, Marc, Jakob, Stephan M, Wittebole, Xavier, Fontes, Luis E, de Melo Gurgel, Miguel, Midega, Thai, Vincent, Jean-Loui, Ranieri, V Marco, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)
Rok vydání: 2021
Předmět:
ARDS
Soins intensifs réanimation
Hospital mortality
medicine.medical_treatment
lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4]
Airway pressures
Respiratory failure
Critical Care and Intensive Care Medicine
Tidal
Cohort Studies
Tidal volume
Plateau pressure
0302 clinical medicine
Mechanical ventilation
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
respiratory insufficiency
Medicine and Health Sciences
030212 general & internal medicine
Hospital Mortality
Prospective Studies
610 Medicine & health
[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases
Respiratory Distress Syndrome
Mortality rate
lcsh:Medical emergencies. Critical care. Intensive care. First aid
Disease Management
TIME
Europe
Intensive Care Units
Airway pressure
[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology
Cohort
Driving pressure
Cohort studies
Respiratory Distress Syndrome/epidemiology
medicine.medical_specialty
respiratorna insuficienca
umetno dihanje
MECHANISMS
Europe/epidemiology
03 medical and health sciences
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Intensive care
SCORE
medicine
Humans
[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology
ddc:610
artificial respiration
udc:616.2
Retrospective Studies
volume
SEPSIS
Intensive Care Units/organization & administration
business.industry
Research
MORTALITY
030208 emergency & critical care medicine
lcsh:RC86-88.9
medicine.disease
[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology
dihalni volumen
VENTILATION
Emergency medicine
business
Zdroj: Critical Care, 25
Critical care, Vol. 25, no.1, p. 87 [1-12] (2021)
Critical care, 25 (1
Sakr, Yasser; François, Bruno; Solé-Violan, Jordi; Kotfis, Katarzyna; Jaschinski, Ulrich; Estella, Angel; Leone, Marc; Jakob, Stephan M.; Wittebole, Xavier; Fontes, Luis E; de Melo Gurgel, Miguel; Midega, Thais; Vincent, Jean-Louis; Ranieri, V Marco (2021). Temporal changes in the epidemiology, management, and outcome from acute respiratory distress syndrome in European intensive care units: a comparison of two large cohorts. Critical care, 25(1), p. 87. BioMed Central 10.1186/s13054-020-03455-8
CRITICAL CARE
Critical Care
Critical Care, Vol 25, Iss 1, Pp 1-12 (2021)
Critical Care, 25, 1
Critical care, vol. 25, pp. 1-12, 2021.
Critical Care, 2021, 25 (1), pp.87. ⟨10.1186/s13054-020-03455-8⟩
ISSN: 1364-8535
1466-609X
DOI: 10.48350/153577
Popis: BACKGROUND: Mortality rates for patients with ARDS remain high. We assessed temporal changes in the epidemiology and management of ARDS patients requiring invasive mechanical ventilation in European ICUs. We also investigated the association between ventilatory settings and outcome in these patients. METHODS: This was a post hoc analysis of two cohorts of adult ICU patients admitted between May 1-15, 2002 (SOAP study, n = 3147), and May 8-18, 2012 (ICON audit, n = 4601 admitted to ICUs in the same 24 countries as the SOAP study). ARDS was defined retrospectively using the Berlin definitions. Values of tidal volume, PEEP, plateau pressure, and FiO2 corresponding to the most abnormal value of arterial PO2 were recorded prospectively every 24 h. In both studies, patients were followed for outcome until death, hospital discharge or for 60 days. RESULTS: The frequency of ARDS requiring mechanical ventilation during the ICU stay was similar in SOAP and ICON (327[10.4%] vs. 494[10.7%], p = 0.793). The diagnosis of ARDS was established at a median of 3 (IQ: 1-7) days after admission in SOAP and 2 (1-6) days in ICON. Within 24 h of diagnosis, ARDS was mild in 244 (29.7%), moderate in 388 (47.3%), and severe in 189 (23.0%) patients. In patients with ARDS, tidal volumes were lower in the later (ICON) than in the earlier (SOAP) cohort. Plateau and driving pressures were also lower in ICON than in SOAP. ICU (134[41.1%] vs 179[36.9%]) and hospital (151[46.2%] vs 212[44.4%]) mortality rates in patients with ARDS were similar in SOAP and ICON. High plateau pressure (> 29 cmH2O) and driving pressure (> 14 cmH2O) on the first day of mechanical ventilation but not tidal volume (> 8 ml/kg predicted body weight [PBW]) were independently associated with a higher risk of in-hospital death. CONCLUSION: The frequency of and outcome from ARDS remained relatively stable between 2002 and 2012. Plateau pressure > 29 cmH2O and driving pressure > 14 cmH2O on the first day of mechanical ventilation but not tidal volume > 8 ml/kg PBW were independently associated with a higher risk of death. These data highlight the continued burden of ARDS and provide hypothesis-generating data for the design of future studies.
SCOPUS: ar.j
info:eu-repo/semantics/published
Databáze: OpenAIRE
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