Publication:
Resolved versus confirmed ARDS after 24 h: insights from the LUNG SAFE study

Issued Date

2018-05-01

Resource Type

Article

ISSN

14321238
03424642

DOI

10.1007/s00134-018-5152-6

Other identifier(s)

2-s2.0-85045095335

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Intensive Care Medicine. Vol.44, No.5 (2018), 564-577

Suggested Citation

Fabiana Madotto, Tài Pham, Giacomo Bellani, Lieuwe D. Bos, Fabienne D. Simonis, Eddy Fan, Antonio Artigas, Laurent Brochard, Marcus J. Schultz, John G. Laffey, Antonio Pesenti, Andres Esteban, Luciano Gattinoni, Frank van Haren, Anders Larsson, Daniel F. McAuley, Marco Ranieri, Gordon Rubenfeld, B. Taylor Thompson, Hermann Wrigge, Arthur S. Slutsky, Fernando Rios, Frank Van Haren, T. Sottiaux, P. Depuydt, Fredy S. Lora, Luciano Cesar Azevedo, Eddy Fan, Guillermo Bugedo, Haibo Qiu, Marcos Gonzalez, Juan Silesky, Vladimir Cerny, Jonas Nielsen, Manuel Jibaja, Dimitrios Matamis, Jorge Luis Ranero, Pravin Amin, S. M. Hashemian, Kevin Clarkson, Kiyoyasu Kurahashi, Asisclo Villagomez, Amine Ali Zeggwagh, Leo M. Heunks, Jon Henrik Laake, Jose Emmanuel Palo, Antero do Vale Fernandes, Dorel Sandesc, Yaasen Arabi, Vesna Bumbasierevic, Nicolas Nin, Jose A. Lorente, Anders Larsson, Lise Piquilloud, Fekri Abroug, Daniel F. McAuley, Lia McNamee, Javier Hurtado, Ed Bajwa, Gabriel Démpaire, Hektor Sula, Lordian Nunci, Alma Cani, Alan Zazu, Christian Dellera, Risso V. Alejandro, Julio Daldin, Mauricio Vinzio, Ruben O. Fernandez, Luis P. Cardonnet, Lisandro R. Bettini, Mariano Carboni Bisso, Emilio M. Osman, Mariano G. Setten, Pablo Lovazzano, Javier Alvarez, Veronica Villar, Norberto C. Pozo, Nicolas Grubissich, Gustavo A. Plotnikow, Daniela N. Vasquez, Santiago Ilutovich, Norberto Tiribelli, Ariel Chena, Carlos A. Pellegrini, María G. Saenz, Elisa Estenssoro, Matias Brizuela, Hernan Gianinetto, Pablo E. Gomez, Valeria I. Cerrato, Marco G. Bezzi, Silvina A. Borello, Flavia A. Loiacono, Adriana M. Fernandez, Serena Knowles, Claire Reynolds, Deborah M. Inskip, Jennene J. Miller Resolved versus confirmed ARDS after 24 h: insights from the LUNG SAFE study. Intensive Care Medicine. Vol.44, No.5 (2018), 564-577. doi:10.1007/s00134-018-5152-6 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/46740

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Title

Resolved versus confirmed ARDS after 24 h: insights from the LUNG SAFE study

Author(s)

Fabiana Madotto
 Tài Pham
 Giacomo Bellani
 Lieuwe D. Bos
 Fabienne D. Simonis
 Eddy Fan
 Antonio Artigas
 Laurent Brochard
 Marcus J. Schultz
 John G. Laffey
 Antonio Pesenti
 Andres Esteban
 Luciano Gattinoni
 Frank van Haren
 Anders Larsson
 Daniel F. McAuley
 Marco Ranieri
 Gordon Rubenfeld
 B. Taylor Thompson
 Hermann Wrigge
 Arthur S. Slutsky
 Fernando Rios
 Frank Van Haren
 T. Sottiaux
 P. Depuydt
 Fredy S. Lora
 Luciano Cesar Azevedo
 Eddy Fan
 Guillermo Bugedo
 Haibo Qiu
 Marcos Gonzalez
 Juan Silesky
 Vladimir Cerny
 Jonas Nielsen
 Manuel Jibaja
 Dimitrios Matamis
 Jorge Luis Ranero
 Pravin Amin
 S. M. Hashemian
 Kevin Clarkson
 Kiyoyasu Kurahashi
 Asisclo Villagomez
 Amine Ali Zeggwagh
 Leo M. Heunks
 Jon Henrik Laake
 Jose Emmanuel Palo
 Antero do Vale Fernandes
 Dorel Sandesc
 Yaasen Arabi
 Vesna Bumbasierevic
 Nicolas Nin
 Jose A. Lorente
 Anders Larsson
 Lise Piquilloud
 Fekri Abroug
 Daniel F. McAuley
 Lia McNamee
 Javier Hurtado
 Ed Bajwa
 Gabriel Démpaire
 Hektor Sula
 Lordian Nunci
 Alma Cani
 Alan Zazu
 Christian Dellera
 Risso V. Alejandro
 Julio Daldin
 Mauricio Vinzio
 Ruben O. Fernandez
 Luis P. Cardonnet
 Lisandro R. Bettini
 Mariano Carboni Bisso
 Emilio M. Osman
 Mariano G. Setten
 Pablo Lovazzano
 Javier Alvarez
 Veronica Villar
 Norberto C. Pozo
 Nicolas Grubissich
 Gustavo A. Plotnikow
 Daniela N. Vasquez
 Santiago Ilutovich
 Norberto Tiribelli
 Ariel Chena
 Carlos A. Pellegrini
 María G. Saenz
 Elisa Estenssoro
 Matias Brizuela
 Hernan Gianinetto
 Pablo E. Gomez
 Valeria I. Cerrato
 Marco G. Bezzi
 Silvina A. Borello
 Flavia A. Loiacono
 Adriana M. Fernandez
 Serena Knowles
 Claire Reynolds
 Deborah M. Inskip
 Jennene J. Miller

Other Contributor(s)

Li Ka Shing Knowledge Institute
 Universitat Autònoma de Barcelona
 Saint Michael's Hospital University of Toronto
 University of Toronto
 University Health Network University of Toronto
 Azienda Ospedaliera San Gerardo Monza
 Mahidol University
 University of Milano - Bicocca
 National University of Ireland Galway
 Amsterdam UMC - University of Amsterdam

Abstract

© 2018, Springer-Verlag GmbH Germany, part of Springer Nature and ESICM. Purpose: To evaluate patients with resolved versus confirmed ARDS, identify subgroups with substantial mortality risk, and to determine the utility of day 2 ARDS reclassification. Methods: Our primary objective, in this secondary LUNG SAFE analysis, was to compare outcome in patients with resolved versus confirmed ARDS after 24 h. Secondary objectives included identifying factors associated with ARDS persistence and mortality, and the utility of day 2 ARDS reclassification. Results: Of 2377 patients fulfilling the ARDS definition on the first day of ARDS (day 1) and receiving invasive mechanical ventilation, 503 (24%) no longer fulfilled the ARDS definition the next day, 52% of whom initially had moderate or severe ARDS. Higher tidal volume on day 1 of ARDS was associated with confirmed ARDS [OR 1.07 (CI 1.01–1.13), P = 0.035]. Hospital mortality was 38% overall, ranging from 31% in resolved ARDS to 41% in confirmed ARDS, and 57% in confirmed severe ARDS at day 2. In both resolved and confirmed ARDS, age, non-respiratory SOFA score, lower PEEP and P/F ratio, higher peak pressure and respiratory rate were each associated with mortality. In confirmed ARDS, pH and the presence of immunosuppression or neoplasm were also associated with mortality. The increase in area under the receiver operating curve for ARDS reclassification on day 2 was marginal. Conclusions: ARDS, whether resolved or confirmed at day 2, has a high mortality rate. ARDS reclassification at day 2 has limited predictive value for mortality. The substantial mortality risk in severe confirmed ARDS suggests that complex interventions might best be tested in this population. Trial Registration: ClinicalTrials.gov NCT02010073.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/46740

Collections

Scopus 2018