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Sökning: WFRF:(Pelosi Paolo) > (2015-2019) > Epidemiological cha...

Epidemiological characteristics, practice of ventilation, and clinical outcome in patients at risk of acute respiratory distress syndrome in intensive care units from 16 countries (PRoVENT) : an international, multicentre, prospective study

Serpa Neto, Ary (författare)
Acad Med Ctr, Dept Intens Care, Amsterdam, Netherlands.;Acad Med Ctr, LEICA, Amsterdam, Netherlands.;Hosp Israelita Albert Einstein, Dept Intens Care Med, Sao Paulo, Brazil.
Barbas, Carmen S. V. (författare)
Hosp Israelita Albert Einstein, Dept Intens Care Med, Sao Paulo, Brazil.;Univ Sao Paulo, Fac Med, Dept Pulmonol, Sao Paulo, Brazil.
Simonis, Fabienne D. (författare)
Acad Med Ctr, Dept Intens Care, Amsterdam, Netherlands.;Acad Med Ctr, LEICA, Amsterdam, Netherlands.
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Artigas-Raventos, Antonio (författare)
Corp Sanitaria & Univ Parc Tauli, CIBER Enfermedades Resp, Hosp Sabadell, Dept Intens Care Med, Sabadell, Spain.
Canet, Jaume (författare)
Hosp Badalona Germans Trias & Pujol, Dept Anesthesiol, Barcelona, Spain.
Determann, Rogier M. (författare)
Westfriesgasthuis, Dept Crit Care, Hoorn, Netherlands.
Anstey, James (författare)
St Vincents Hosp, Dept Intens Care, Melbourne, Vic, Australia.
Hedenstierna, Göran (författare)
Uppsala universitet,Klinisk fysiologi
Hemmes, Sabrine N. T. (författare)
Acad Med Ctr, Dept Anesthesiol, Amsterdam, Netherlands.
Hermans, Greet (författare)
Univ Hosp Leuven, Div Gen Internal Med, Med Intens Care Unit, Leuven, Belgium.;Katholieke Univ Leuven, Dept Cellular & Mol Med, Lab Intens Care Med, Leuven, Belgium.
Hiesmayr, Michael (författare)
Med Univ Vienna, Div Cardiac Thorac & Vasc Anesthesia & Intens Car, Vienna, Austria.
Hollmann, Markus W. (författare)
Acad Med Ctr, Dept Anesthesiol, Amsterdam, Netherlands.
Jaber, Samir (författare)
St Eloi Univ Hosp, Dept Crit Care Med & Anesthesiol SAR B, Montpellier, France.
Martin-Loeches, Ignacio (författare)
St James Hosp, Trinity Ctr Hlth Sci, MICRO, Dept Clin Med, Dublin, Ireland.
Mills, Gary H. (författare)
Sheffield Teaching Hosp, Dept Anaesthesia & Crit Care Med, Sheffield, S Yorkshire, England.
Pearse, Rupert M. (författare)
Queen Mary Univ London, Barts & London Sch Med & Dent, London, England.
Putensen, Christian (författare)
Univ Hosp Bonn, Dept Anesthesiol & Intens Care Med, Bonn, Germany.
Schmid, Werner (författare)
Med Univ Vienna, Div Cardiac Thorac & Vasc Anesthesia & Intens Car, Vienna, Austria.
Severgnini, Paolo (författare)
Insubria Univ, Dept Biotechnol & Sci Life, Varese, Italy.
Smith, Roger (författare)
St Vincents Hosp, Dept Intens Care, Melbourne, Vic, Australia.
Treschan, Tanja A. (författare)
Dusseldorf Univ Hosp, Dept Anaesthesiol, Dusseldorf, Germany.
Tschernko, Edda M. (författare)
Med Univ Vienna, Div Cardiac Thorac & Vasc Anesthesia & Intens Car, Vienna, Austria.
Melo, Marcos F. V. (författare)
Harvard Med Sch, Massachusetts Gen Hosp, Dept Anesthesia Crit Care & Pain Med, Boston, MA USA.
Wrigge, Hermann (författare)
Univ Leipzig, Dept Anesthesiol & Intens Care Med, Leipzig, Germany.
de Abreu, Marcelo Gama (författare)
Univ Hosp Carl Gustav Carus, Pulm Engn Grp, Dept Anesthesiol & Intens Care Med, Dresden, Germany.;Tech Univ Dresden, Dresden, Germany.
Pelosi, Paolo (författare)
Univ Genoa, IRCCS San Martino IST, Dept Surg Sci & Integrated Diagnost, Genoa, Italy.
Schultz, Marcus J. (författare)
Acad Med Ctr, Dept Intens Care, Amsterdam, Netherlands.;Acad Med Ctr, LEICA, Amsterdam, Netherlands.
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Acad Med Ctr, Dept Intens Care, Amsterdam, Netherlands;Acad Med Ctr, LEICA, Amsterdam, Netherlands.;Hosp Israelita Albert Einstein, Dept Intens Care Med, Sao Paulo, Brazil. Hosp Israelita Albert Einstein, Dept Intens Care Med, Sao Paulo, Brazil.;Univ Sao Paulo, Fac Med, Dept Pulmonol, Sao Paulo, Brazil. (creator_code:org_t)
2016
2016
Engelska.
Ingår i: The Lancet Respiratory Medicine. - 2213-2600 .- 2213-2619. ; 4:11, s. 882-893
Relaterad länk:
https://urn.kb.se/re...
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https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Background Scant information exists about the epidemiological characteristics and outcome of patients in the intensive care unit (ICU) at risk of acute respiratory distress syndrome (ARDS) and how ventilation is managed in these individuals. We aimed to establish the epidemiological characteristics of patients at risk of ARDS, describe ventilation management in this population, and assess outcomes compared with people at no risk of ARDS. Methods PRoVENT (PRactice of VENTilation in critically ill patients without ARDS at onset of ventilation) is an international, multicentre, prospective study undertaken at 119 ICUs in 16 countries worldwide. All patients aged 18 years or older who were receiving mechanical ventilation in participating ICUs during a 1-week period between January, 2014, and January, 2015, were enrolled into the study. The Lung Injury Prediction Score (LIPS) was used to stratify risk of ARDS, with a score of 4 or higher defining those at risk of ARDS. The primary outcome was the proportion of patients at risk of ARDS. Secondary outcomes included ventilatory management (including tidal volume [V-T] expressed as mL/kg predicted bodyweight [PBW], and positive end-expiratory pressure [PEEP] expressed as cm H2O), development of pulmonary complications, and clinical outcomes. The PRoVENT study is registered at ClinicalTrials.gov, NCT01868321. The study has been completed. Findings Of 3023 patients screened for the study, 935 individuals fulfilled the inclusion criteria. Of these critically ill patients, 282 were at risk of ARDS (30%, 95% CI 27-33), representing 0.14 cases per ICU bed over a 1-week period. V-T was similar for patients at risk and not at risk of ARDS (median 7.6 mL/kg PBW [IQR 6.7-9.1] vs 7.9 mL/kg PBW [6.8-9.1]; p=0.346). PEEP was higher in patients at risk of ARDS compared with those not at risk (median 6.0 cm H2O [IQR 5.0-8.0] vs 5.0 cm H2O [5.0-7.0]; p<0.0001). The prevalence of ARDS in patients at risk of ARDS was higher than in individuals not at risk of ARDS (19/260 [7%] vs 17/556 [3%]; p=0.004). Compared with individuals not at risk of ARDS, patients at risk of ARDS had higher in-hospital mortality (86/543 [16%] vs 74/232 [32%]; p<0.0001), ICU mortality (62/533 [12%] vs 66/227 [29%]; p<0.0001), and 90-day mortality (109/653 [17%] vs 88/282 [31%]; p<0. 0001). V-T did not differ between patients who did and did not develop ARDS (p=0.471 for those at risk of ARDS; p=0.323 for those not at risk). Interpretation Around a third of patients receiving mechanical ventilation in the ICU were at risk of ARDS. Pulmonary complications occur frequently in patients at risk of ARDS and their clinical outcome is worse compared with those not at risk of ARDS. There is potential for improvement in the management of patients without ARDS. Further refinements are needed for prediction of ARDS.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)

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