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Title: Potentially modifiable respiratory variables contributing to outcome in ICU patients without ARDS: a secondary analysis of PRoVENT
Authors: Fabienne D. Simonis
Carmen S.V. Barbas
Antonio Artigas-Raventós
Jaume Canet
Rogier M. Determann
James Anstey
Goran Hedenstierna
Sabrine N.T. Hemmes
Greet Hermans
Michael Hiesmayr
Markus W. Hollmann
Samir Jaber
Ignacio Martin-Loeches
Gary H. Mills
Rupert M. Pearse
Christian Putensen
Werner Schmid
Paolo Severgnini
Roger Smith
Tanja A. Treschan
Edda M. Tschernko
Marcos F. Vidal Melo
Hermann Wrigge
Marcelo Gama de Abreu
Paolo Pelosi
Marcus J. Schultz
Ary Serpa Neto
Barry Dixon
Uniklinik Düsseldorf
KU Leuven– University Hospital Leuven
Universitäts-Klinikum Bonn und Medizinische Fakultät
Massachusetts General Hospital
Hospital Universitari Germans Trias i Pujol
Hopital Saint-Eloi
Dresden University Faculty of Medicine and University Hospital Carl Gustav Carus
Università degli Studi di Genova
KU Leuven
Barts and The London School of Medicine and Dentistry
Technische Universität Dresden
Hospital Israelita Albert Einstein
Mahidol University
Medizinische Universitat Wien
Trinity College Dublin
Hospital de Sabadell
Universidade de Sao Paulo - USP
Universität Leipzig
Università degli Studi dell'Insubria
Uppsala Universitet
St. Vincent's Hospital Melbourne
Amsterdam UMC - University of Amsterdam
Irish Centre for Vascular Biology
Sheffield Teaching Hospital
Keywords: Medicine
Issue Date: 1-Dec-2018
Citation: Annals of Intensive Care. Vol.8, No.1 (2018)
Abstract: © 2018, The Author(s). Background: The majority of critically ill patients do not suffer from acute respiratory distress syndrome (ARDS). To improve the treatment of these patients, we aimed to identify potentially modifiable factors associated with outcome of these patients. Methods: The PRoVENT was an international, multicenter, prospective cohort study of consecutive patients under invasive mechanical ventilatory support. A predefined secondary analysis was to examine factors associated with mortality. The primary endpoint was all-cause in-hospital mortality. Results: 935 Patients were included. In-hospital mortality was 21%. Compared to patients who died, patients who survived had a lower risk of ARDS according to the ‘Lung Injury Prediction Score’ and received lower maximum airway pressure (Pmax), driving pressure (ΔP), positive end-expiratory pressure, and FiO2 levels. Tidal volume size was similar between the groups. Higher Pmax was a potentially modifiable ventilatory variable associated with in-hospital mortality in multivariable analyses. ΔP was not independently associated with in-hospital mortality, but reliable values for ΔP were available for 343 patients only. Non-modifiable factors associated with in-hospital mortality were older age, presence of immunosuppression, higher non-pulmonary sequential organ failure assessment scores, lower pulse oximetry readings, higher heart rates, and functional dependence. Conclusions: Higher Pmax was independently associated with higher in-hospital mortality in mechanically ventilated critically ill patients under mechanical ventilatory support for reasons other than ARDS. Trial Registration (NCT01868321).
ISSN: 21105820
Appears in Collections:Scopus 2018

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