Potentially modifiable factors contributing to outcome from acute respiratory distress syndrome: the LUNG SAFE study

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Fältnamn	Indikatorer	Metadata
000		05020naa a2200697 4500
001		oai:DiVA.org:uu-307916
003		SwePub
008		161122s2016 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3079162 URI
024	7	a https://doi.org/10.1007/s00134-016-4571-52 DOI
040		a (SwePub)uu
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Laffey, John G4 aut
245	1 0	a Potentially modifiable factors contributing to outcome from acute respiratory distress syndrome :b the LUNG SAFE study
264		c 2016-10-18
264	1	b Springer,c 2016
338		a print2 rdacarrier
500		a A Correction to this article was published on 14 November 2017. Corrected and republished: Intensive Care Med (2016) 42:1865–1876 DOI 10.1007/s00134-016-4571-5A correction to this article is available online at https://doi.org/10.1007/s00134-017-4981-z. Intensive Care Med 44, 157–165 (2018).
520		a Purpose: To improve the outcome of the acute respiratory distress syndrome (ARDS), one needs to identify potentially modifiable factors associated with mortality.Methods: The large observational study to understand the global impact of severe acute respiratory failure (LUNG SAFE) was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted in the winter of 2014 in a convenience sample of 459 ICUs from 50 countries across five continents. A pre-specified secondary aim was to examine the factors associated with outcome. Analyses were restricted to patients (93.1 %) fulfilling ARDS criteria on day 1-2 who received invasive mechanical ventilation.Result: 2377 patients were included in the analysis. Potentially modifiable factors associated with increased hospital mortality in multivariable analyses include lower PEEP, higher peak inspiratory, plateau, and driving pressures, and increased respiratory rate. The impact of tidal volume on outcome was unclear. Having fewer ICU beds was also associated with higher hospital mortality. Non-modifiable factors associated with worsened outcome from ARDS included older age, active neoplasm, hematologic neoplasm, and chronic liver failure. Severity of illness indices including lower pH, lower PaO2/FiO2 ratio, and higher non-pulmonary SOFA score were associated with poorer outcome. Of the 578 (24.3 %) patients with a limitation of life-sustaining therapies or measures decision, 498 (86.0 %) died in hospital. Factors associated with increased likelihood of limitation of life-sustaining therapies or measures decision included older age, immunosuppression, neoplasia, lower pH and increased non-pulmonary SOFA scores.Conclusions: Higher PEEP, lower peak, plateau, and driving pressures, and lower respiratory rate are associated with improved survival from ARDS.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Anestesi och intensivvård0 (SwePub)302012 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Anesthesiology and Intensive Care0 (SwePub)302012 hsv//eng
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Lungmedicin och allergi0 (SwePub)302192 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Respiratory Medicine and Allergy0 (SwePub)302192 hsv//eng
653		a Acute respiratory distress syndrome
653		a Positive end-expiratory pressure
653		a Patient outcome
653		a Driving pressure
653		a Peak inspiratory pressure
700	1	a Bellani, Giacomo4 aut
700	1	a Pham, Tài4 aut
700	1	a Fan, Eddy4 aut
700	1	a Madotto, Fabiana4 aut
700	1	a Bajwa, Ednan K4 aut
700	1	a Brochard, Laurent4 aut
700	1	a Clarkson, Kevin4 aut
700	1	a Esteban, Andres4 aut
700	1	a Gattinoni, Luciano4 aut
700	1	a van Haren, Frank4 aut
700	1	a Heunks, Leo M4 aut
700	1	a Kurahashi, Kiyoyasu4 aut
700	1	a Laake, Jon Henrik4 aut
700	1	a Larsson, Andersu Uppsala universitet,Hedenstiernalaboratoriet4 aut0 (Swepub:uu)andla606
700	1	a McAuley, Daniel F4 aut
700	1	a McNamee, Lia4 aut
700	1	a Nin, Nicolas4 aut
700	1	a Qiu, Haibo4 aut
700	1	a Ranieri, Marco4 aut
700	1	a Rubenfeld, Gordon D4 aut
700	1	a Thompson, B Taylor4 aut
700	1	a Wrigge, Hermann4 aut
700	1	a Slutsky, Arthur S4 aut
700	1	a Pesenti, Antonio4 aut
710	2	a Uppsala universitetb Hedenstiernalaboratoriet4 org
773	0	t Intensive Care Medicined : Springerg 42:12, s. 1865-1876q 42:12<1865-1876x 0342-4642x 1432-1238
856	4	u https://link.springer.com/article/10.1007/s00134-016-4571-5y To The Article
856	4	u https://link.springer.com/content/pdf/10.1007/s00134-016-4571-5.pdf
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-307916
856	4 8	u https://doi.org/10.1007/s00134-016-4571-5

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Anesthesiology a ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Respiratory Medi ...

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