Publication:
Evolution Over Time of Ventilatory Management and Outcome of Patients With Neurologic Disease∗

Issued Date

2021-07-01

Resource Type

Article

ISSN

15300293
00903493

DOI

10.1097/CCM.0000000000004921

Other identifier(s)

2-s2.0-85108386465

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Critical Care Medicine. Vol.49, No.7 (2021), 1095-1106

Suggested Citation

Eva E. Tejerina, Paolo Pelosi, Chiara Robba, Oscar Peñuelas, Alfonso Muriel, Deisy Barrios, Fernando Frutos-Vivar, Konstantinos Raymondos, Bin Du, Arnaud W. Thille, Fernando Ríos, Marco González, Lorenzo Del-Sorbo, Maria del Carmen Marín, Bruno Valle Pinheiro, Marco Antonio Soares, Nicolas Nin, Salvatore M. Maggiore, Andrew Bersten, Pravin Amin, Nahit Cakar, Gee Young Suh, Fekri Abroug, Manuel Jibaja, Dimitros Matamis, Amine Ali Zeggwagh, Yuda Sutherasan, Antonio Anzueto, Andrés Esteban Evolution Over Time of Ventilatory Management and Outcome of Patients With Neurologic Disease∗. Critical Care Medicine. Vol.49, No.7 (2021), 1095-1106. doi:10.1097/CCM.0000000000004921 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/78081

Research Projects

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Journal Issue

Thesis

Title

Evolution Over Time of Ventilatory Management and Outcome of Patients With Neurologic Disease∗

Author(s)

Eva E. Tejerina
 Paolo Pelosi
 Chiara Robba
 Oscar Peñuelas
 Alfonso Muriel
 Deisy Barrios
 Fernando Frutos-Vivar
 Konstantinos Raymondos
 Bin Du
 Arnaud W. Thille
 Fernando Ríos
 Marco González
 Lorenzo Del-Sorbo
 Maria del Carmen Marín
 Bruno Valle Pinheiro
 Marco Antonio Soares
 Nicolas Nin
 Salvatore M. Maggiore
 Andrew Bersten
 Pravin Amin
 Nahit Cakar
 Gee Young Suh
 Fekri Abroug
 Manuel Jibaja
 Dimitros Matamis
 Amine Ali Zeggwagh
 Yuda Sutherasan
 Antonio Anzueto
 Andrés Esteban

Other Contributor(s)

IRCCS San Martino Polyclinic Hospital
 Hospital Regional 1° de Octubre ISSSTE
 CHU Fattouma-Bourguiba
 Universidad Pontificia Bolivariana
 Universidad de Alcalá
 Medizinische Hochschule Hannover (MHH)
 Hospital Ramon y Cajal
 Centre Hospitalier Universitaire de Poitiers
 Samsung Medical Center, Sungkyunkwan University
 Flinders University
 Mohammed V University in Rabat
 University of Texas Health Science Center at San Antonio
 Faculty of Medicine Ramathibodi Hospital, Mahidol University
 Papageorgiou General Hospital
 İstanbul Tıp Fakültesi
 Bombay Hospital and Medical Research Centre
 Peking Union Medical College Hospital
 Hospital Nacional Professor Dr. Alejandro Posadas
 University of G. d'Annunzio Chieti and Pescara
 Hospital Universitario de Getafe
 Universidade Federal de Juiz de Fora
 Hospital de Especialidades Eugenio Espejo
 Hospital Universitario de Montevideo
 Interdepartmental Division of Critical Care Medicine
 Hospital Universitario Sao Jose

Abstract

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/123456789/78081

Collections

Scopus 2021