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Geoeconomic variati...
Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome : a pooled analysis of four observational studies
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- Pisani, Luigi (författare)
- Mahidol University,Doctors with Africa CUAMM,Miulli General Hospital,Academic Medical Center of University of Amsterdam (AMC)
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- Algera, Anna Geke (författare)
- Academic Medical Center of University of Amsterdam (AMC)
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- Neto, Ary Serpa (författare)
- Monash University,Austin Hospital,Melbourne Medical School,Australian and New Zealand Intensive Care Research Centre,Albert Einstein Israelite Hospital
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- Azevedo, Luciano Cesar (författare)
- University of São Paulo
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- Pham, Tài (författare)
- Li Ka Shing Knowledge Institute,University of Toronto
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- Paulus, Frederique (författare)
- Academic Medical Center of University of Amsterdam (AMC)
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- de Abreu, Marcelo Gama (författare)
- University Clinic Carl Gustav Carus at the TU Dresden
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- Pelosi, Paolo (författare)
- University of Genoa,Ospedale Policlinico San Martino
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- Dondorp, Arjen M. (författare)
- Mahidol University,University of Oxford
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- Bellani, Giacomo (författare)
- University of Milano-Bicocca
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- Laffey, John G. (författare)
- Galway University Hospital
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- Schultz, Marcus J. (författare)
- Mahidol University,Academic Medical Center of University of Amsterdam (AMC)
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Martinez, Amadeu (författare)
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Leal, Livia (författare)
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Jorge Pereira, Antonio (författare)
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de Oliveira Maia, Marcelo (författare)
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Neto, Josè Aires (författare)
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Piras, Claudio (författare)
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Caser, Eliana Bernadete (författare)
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Moreira, Cora Lavigne (författare)
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Braga Gusman, Pablo (författare)
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Dalcomune, Dyanne Moysés (författare)
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Ribeiro de Carvalho, Alexandre Guilherme (författare)
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Gondim, Louise Aline Romão (författare)
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Castelo Branco Reis, Lívia Mariane (författare)
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da Cunha Ribeiro, Daniel (författare)
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de Assis Simões, Leonardo (författare)
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Campos, Rafaela Siqueira (författare)
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Fernandez Versiani dos Anjos, José Carlos (författare)
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Bruzzi Carvalho, Frederico (författare)
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Alves, Rossine Ambrosio (författare)
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Nunes, Lilian Batista (författare)
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Réa-Neto, Álvaro (författare)
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de Oliveira, Mirella Cristine (författare)
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Tannous, Luana (författare)
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Cardoso Gomes, Brenno (författare)
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Rodriguez, Fernando Borges (författare)
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Abelha, Priscila (författare)
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Larsson, Anders (författare)
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Liu, Haitao (författare)
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Wang, Wei (författare)
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Zhang, Fan (författare)
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Liu, Jian (författare)
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Li, Bin (författare)
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Liu, Jing L. (författare)
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Li, Yuan Y. (författare)
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Oliveira, Bruno S. (författare)
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Larsson, Niklas (författare)
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Smith, Roger (författare)
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- Kander, Thomas (creator_code:cre_t)
- Lund University,Lunds universitet,Klinisk forskning inom anestesi och intensivvårdsmedicin,Forskargrupper vid Lunds universitet,Clinical Research in Anaesthesia and Intensive Care Medicine,Lund University Research Groups
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- 2022
- 2022
- Engelska.
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Ingår i: The Lancet Global Health. - 2214-109X. ; 10:2, s. 227-235
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference –1·69 [–9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5–8] vs 6 [5–8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52–23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75–0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status. Funding: No funding.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
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Pisani, Luigi
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Algera, Anna Gek ...
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Neto, Ary Serpa
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Azevedo, Luciano ...
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Pham, Tài
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Paulus, Frederiq ...
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visa fler...
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de Abreu, Marcel ...
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Pelosi, Paolo
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Dondorp, Arjen M ...
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Bellani, Giacomo
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Laffey, John G.
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Schultz, Marcus ...
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Martinez, Amadeu
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Leal, Livia
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Jorge Pereira, A ...
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de Oliveira Maia ...
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Neto, Josè Aires
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Piras, Claudio
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Caser, Eliana Be ...
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Moreira, Cora La ...
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Braga Gusman, Pa ...
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Dalcomune, Dyann ...
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Ribeiro de Carva ...
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Gondim, Louise A ...
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Castelo Branco R ...
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da Cunha Ribeiro ...
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de Assis Simões, ...
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Campos, Rafaela ...
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Fernandez Versia ...
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Bruzzi Carvalho, ...
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Alves, Rossine A ...
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Nunes, Lilian Ba ...
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Réa-Neto, Álvaro
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de Oliveira, Mir ...
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Tannous, Luana
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Cardoso Gomes, B ...
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Rodriguez, Ferna ...
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Abelha, Priscila
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Larsson, Anders
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Liu, Haitao
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Wang, Wei
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Zhang, Fan
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Liu, Jian
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Li, Bin
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Liu, Jing L.
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Li, Yuan Y.
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Oliveira, Bruno ...
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Larsson, Niklas
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Smith, Roger
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Kander, Thomas
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Anestesi och int ...
- Artiklar i publikationen
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The Lancet Globa ...
- Av lärosätet
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Lunds universitet