Publication:
Epidemiological characteristics, ventilator management, and clinical outcome in patients receiving invasive ventilation in intensive care units from 10 Asian middle-income countries (PRoVENT-iMiC): An international, multicenter, prospective study

Issued Date

2021-03-01

Resource Type

Article

ISSN

14761645
00029637

DOI

10.4269/ajtmh.20-1177

Other identifier(s)

2-s2.0-85103166193

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

American Journal of Tropical Medicine and Hygiene. Vol.104, No.3 (2021), 1022-1033

Suggested Citation

Luigi Pisani, Anna Geke Algera, Ary Serpa Neto, Areef Ahsan, Abigail Beane, Kaweesak Chittawatanarat, Abul Faiz, Rashan Haniffa, Seyed Mohammad Reza Hashemian, Madiha Hashmi, Hisham Ahmed Imad, Kanishka Indraratna, Shivakumar Iyer, Gyan Kayastha, Bhuvana Krishna, Tai Li Ling, Hassan Moosa, Behzad Nadjm, Rajyabardhan Pattnaik, Sriram Sampath, Louise Thwaites, Ni Ni Tun, Norazim Mohd Yunos, Salvatore Grasso, Frederique Paulus, Marcelo Gama de Abreu, Paolo Pelosi, Nick Day, Nicholas J. White, Arjen M. Dondorp, Marcus J. Schultz Epidemiological characteristics, ventilator management, and clinical outcome in patients receiving invasive ventilation in intensive care units from 10 Asian middle-income countries (PRoVENT-iMiC): An international, multicenter, prospective study. American Journal of Tropical Medicine and Hygiene. Vol.104, No.3 (2021), 1022-1033. doi:10.4269/ajtmh.20-1177 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77317

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Title

Epidemiological characteristics, ventilator management, and clinical outcome in patients receiving invasive ventilation in intensive care units from 10 Asian middle-income countries (PRoVENT-iMiC): An international, multicenter, prospective study

Author(s)

Luigi Pisani
 Anna Geke Algera
 Ary Serpa Neto
 Areef Ahsan
 Abigail Beane
 Kaweesak Chittawatanarat
 Abul Faiz
 Rashan Haniffa
 Seyed Mohammad Reza Hashemian
 Madiha Hashmi
 Hisham Ahmed Imad
 Kanishka Indraratna
 Shivakumar Iyer
 Gyan Kayastha
 Bhuvana Krishna
 Tai Li Ling
 Hassan Moosa
 Behzad Nadjm
 Rajyabardhan Pattnaik
 Sriram Sampath
 Louise Thwaites
 Ni Ni Tun
 Norazim Mohd Yunos
 Salvatore Grasso
 Frederique Paulus
 Marcelo Gama de Abreu
 Paolo Pelosi
 Nick Day
 Nicholas J. White
 Arjen M. Dondorp
 Marcus J. Schultz

Other Contributor(s)

Universitätsklinikum Carl Gustav Carus Dresden
 Faculty of Tropical Medicine, Mahidol University
 Oxford University Clinical Research Unit
 IRCCS San Martino Polyclinic Hospital
 Bharati Vidyapeeth Medical College, Pune
 Indira Gandhi Memorial Hospital Male
 Sri Jayewardenepura General Hospital
 Ispat General Hospital
 The Aga Khan University
 Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders
 Kuala Lumpur Hospital
 Università degli Studi di Genova
 Università degli studi di Bari Aldo Moro
 Shahid Beheshti University of Medical Sciences
 Hospital Israelita Albert Einstein
 University of Malaya Medical Centre
 Nuffield Department of Medicine
 Amsterdam UMC - University of Amsterdam
 Chiang Mai University
 19Medical Action Myanmar
 St. John’s Medical College
 Dev Care Foundation
 Patan Academy of Health Sciences

Abstract

Epidemiology, ventilator management, and outcome in patients receiving invasive ventilation in intensive care units (ICUs) in middle-income countries are largely unknown. PRactice of VENTilation in Middle-income Countries is an international multicenter 4-week observational study of invasively ventilated adult patients in 54 ICUs from 10 Asian countries conducted in 2017/18. Study outcomes included major ventilator settings (including tidal volume [VT] and positive end-expiratory pressure [PEEP]); the proportion of patients at risk for acute respiratory distress syndrome (ARDS), according to the lung injury prediction score (LIPS), or with ARDS; the incidence of pulmonary complications; and ICU mortality. In 1,315 patients included, median VT was similar in patients with LIPS < 4 and patients with LIPS 3 4, but lower in patients with ARDS (7.90 [6.8–8.9], 8.0 [6.8–9.2], and 7.0 [5.8–8.4] mL/kg Predicted body weight; P = 0.0001). Median PEEP was similar in patients with LIPS < 4 and LIPS 3 4, but higher in patients with ARDS (five [5–7], five [5–8], and 10 [5–12] cmH2O; P < 0.0001). The proportions of patients with LIPS 3 4 or with ARDS were 68% (95% CI: 66–71) and 7% (95% CI: 6–8), respectively. Pulmonary complications increased stepwise from patients with LIPS < 4 to patients with LIPS 3 4 and patients with ARDS (19%, 21%, and 38% respectively; P = 0.0002), with a similar trend in ICU mortality (17%, 34%, and 45% respectively; P < 0.0001). The capacity of the LIPS to predict development of ARDS was poor (receiver operating characteristic [ROC] area under the curve [AUC] of 0.62, 95% CI: 0.54–0.70). In Asian middle-income countries, where two-thirds of ventilated patients are at risk for ARDS according to the LIPS and pulmonary complications are frequent, setting of VT is globally in line with current recommendations.

Keyword(s)

Immunology and Microbiology
 Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/77317

Collections

Scopus 2021