المؤلفون: Demoule, Alexandre, Antonelli, Massimo, Schellongowski, Peter, Pickkers, Peter, Soares, Marcio, Meyhoff, Tine, Rello, Jordi, Bauer, Philippe R., van de Louw, Andry, Lemiale, Virgine, Grimaldi, David, Martin-Loeches, Ignacio, Balik, Martin, Mehta, Sangeeta, Kouatchet, Achille, Barratt-Due, Andreas, Valkonen, Miia, Reignier, Jean, Metaxa, Victoria, Moreau, Anne-Sophie, Burghi, Gaston, Mokart, Djamel, Mayaux, Julien, Darmon, Michael, Azoulay, Elie, Amrein, Karin, Staundinger, Thomas, Heinz, Gottfried, Sengölge, Gürkan, Zauner, Christian, Jaksch, Peter, Taccone, Fabio S., Meert, Anne Pascale, Benoît, Dominique, Silva, Ulysses V.A., Pierre de Moraes, Ana Paula, Lishoa, Thiago, Salluh, Jorge, Viana, William, Moralez, Guilliana, Correa, Thiago Domingos, Shah, Umesh, Karvunidis, Thomas, Martin, Balik, Russinova, Katerina, Perner, Anders

المساهمون: Baxter, Philips, Chiesi, Novo Nordisk, Pfizer, Astellas, Alexion, Ablynx

المصدر: Chest ; volume 158, issue 5, page 1947-1957 ; ISSN 0012-3692

مصطلحات موضوعية: Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, Pulmonary and Respiratory Medicine

الإتاحة: https://doi.org/10.1016/j.chest.2020.05.602Test
https://api.elsevier.com/content/article/PII:S0012369220317177?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0012369220317177?httpAccept=text/plainTest

المؤلفون: Demoule, Alexandre, Antonelli, Massimo, Schellongowski, Peter, Pickkers, Peter, Soares, Marcio, Meyhoff, Tine Sylvest, Rello, Jordi, Bauer, Philippe, van de Louw, Andry, Lemiale, Virgine, Grimaldi, David, Martin-Loeches, Ignacio, Balik, Martin, Mehta, Sangeeta, Kouatchet, Achille, Barratt-Due, Andreas, Valkonen, Miia, Reignier, Jean, Metaxa, Victoria, Moreau, Anne Sophie, Burghi, Gaston, Mokart, Djamel, Mayaux, Julien, Darmon, Michael, Azoulay, Elie, Amrein, Karin, Staundinger, Thomas, Heinz, Gottfried, Sengölge, Gürkan, Zauner, Christian, Jaksch, Peter, Taccone, Fabio S., Meert, Anne Pascale, Benoît, Dominique, Silva, Ulysses V.A., Pierre de Moraes, Ana Paula, Lishoa, Thiago, Salluh, Jorge, Viana, William, Moralez, Guilliana, Correa, Thiago Domingos, Shah, Umesh, Karvunidis, Thomas, Martin, Balik, Russinova, Katerina, Perner, Anders, Jonas, Nielsen, Bukan, Ramin Brandt, Moeller, Ann M., Nielsen, Lene B., Seguin, Amélie, Chermak, Akli, Terzi, Nicolas, Vinatier, Isabelle, Wallet, Florent, Klouche, Kada, Platon, Laura, Gaborit, Benjamin, Barbier, François, Pène, Frederic, Rabbat, Antoine, Lemiale, Virginie, N'Yunga, Martine, Girault, Christophe, Lemaitre, Caroline, Artaud-Macari, Elise, Bruneel, F., Kuitunen, Anne, Marsh, Brian, Misericordia, Mater, Mahon, Aisling Mc, Cinnella, Gilda, Cotoia, Antonella, Riuniti, Ospedali, Montini, Lucas, Spoelstra de Man, Angélique, Landburg, Precious Pearl, Bergmans, Dennis, Hemelaar, Pleun, Kaufmann, Thomas, Barrat-Due, Andreas, Klepstad, Pål, Encina, Belen, Moreno, Gabriel, Crespi, Llorenç Socias, Rodriguez-Ruiz, Emilio, Hemang, Yadav

المصدر: Demoule , A , Antonelli , M , Schellongowski , P , Pickkers , P , Soares , M , Meyhoff , T S , Rello , J , Bauer , P , van de Louw , A , Lemiale , V , Grimaldi , D , Martin-Loeches , I , Balik , M , Mehta , S , Kouatchet , A , Barratt-Due , A , Valkonen , M , Reignier , J , Metaxa , V , Moreau , A S , Burghi , G , Mokart , D , Mayaux , J , Darmon , M ....

مصطلحات موضوعية: demo, envir

الوصف: Background: In view of the high mortality rate of immunocompromised patients with ARDS, it is important to identify targets for improvement. Research Question: This study investigated factors associated with mortality in this specific ARDS population, including factors related to respiratory mechanics (plateau pressure [Pplat,rs], compliance [Crs], and driving pressure [ΔPrs]). Study Design and Methods: This study consisted of a predefined secondary analysis of the EFRAIM data. Overall, 789 of 1,611 patients met the Berlin criteria for ARDS, and Pplat,rs, ΔPrs, and Crs were available for 494 patients. A hierarchical model was used to assess factors at ARDS onset independently associated with hospital mortality. Results: Hospital mortality was 56.3%. After adjustment, variables independently associated with hospital mortality included ARDS of undetermined etiology (OR, 1.66; 95% CI, 1.01-2.72), need for vasopressors (OR, 1.91; 95% CI, 1.27-2.88), and need for renal replacement therapy (OR, 2.02; 95% CI, 1.37-2.97). ARDS severity according to the Berlin definition, neutropenia on admission, and the type of underlying disease were not significantly associated with mortality. Before adjustment, higher Pplat,rs, higher ΔPrs, and lower Crs were associated with higher mortality. Addition of each of these individual variables to the final hierarchical model revealed a significant association with mortality: ΔPrs (OR, 1.08; 95% CI, 1.05-1.12), Pplat,rs (OR, 1.07; 95% CI, 1.04-1.11), and Crs (OR, 0.97; 95% CI, 0.95-0.98). Tidal volume was not associated with mortality. Interpretation: In immunocompromised patients with ARDS, respiratory mechanics provide additional prognostic information to predictors of hospital mortality. Studies designed to define lung-protective ventilation guided by these physiological variables may be warranted in this specific population.

العلاقة: https://research.vumc.nl/en/publications/e2fa676e-0048-45c6-9384-bf9771fb51e5Test

الإتاحة: https://doi.org/10.1016/j.chest.2020.05.602Test
https://research.vumc.nl/en/publications/e2fa676e-0048-45c6-9384-bf9771fb51e5Test

المؤلفون: Demoule, Alexandre, Antonelli, Massimo, Schellongowski, Peter, Pickkers, Peter, Soares, Marcio, Meyhoff, Tine Sylvest, Rello, Jordi, Bauer, Philippe, van de Louw, Andry, Lemiale, Virgine, Grimaldi, David, Martin-Loeches, Ignacio, Balik, Martin, Mehta, Sangeeta, Kouatchet, Achille, Barratt-Due, Andreas, Valkonen, Miia, Reignier, Jean, Metaxa, Victoria, Moreau, Anne Sophie, Burghi, Gaston, Mokart, Djamel, Mayaux, Julien, Darmon, Michael, Azoulay, Elie, Amrein, Karin, Staundinger, Thomas, Heinz, Gottfried, Sengölge, Gürkan, Zauner, Christian, Jaksch, Peter, Taccone, Fabio S., Meert, Anne Pascale, Benoît, Dominique, Silva, Ulysses V.A., Pierre de Moraes, Ana Paula, Lishoa, Thiago, Salluh, Jorge, Viana, William, Moralez, Guilliana, Correa, Thiago Domingos, Shah, Umesh, Karvunidis, Thomas, Martin, Balik, Russinova, Katerina, Perner, Anders, Jonas, Nielsen, Bukan, Ramin Brandt, Moeller, Ann M., Nielsen, Lene B., Seguin, Amélie, Chermak, Akli, Terzi, Nicolas, Vinatier, Isabelle, Wallet, Florent, Klouche, Kada, Platon, Laura, Gaborit, Benjamin, Barbier, François, Pène, Frederic, Rabbat, Antoine, Lemiale, Virginie, N'Yunga, Martine, Girault, Christophe, Lemaitre, Caroline, Artaud-Macari, Elise, Bruneel, F., Kuitunen, Anne, Marsh, Brian, Misericordia, Mater, Mahon, Aisling Mc, Cinnella, Gilda, Cotoia, Antonella, Riuniti, Ospedali, Montini, Lucas, Spoelstra de Man, Angélique, Landburg, Precious Pearl, Bergmans, Dennis, Hemelaar, Pleun, Kaufmann, Thomas, Barrat-Due, Andreas, Klepstad, Pål, Encina, Belen, Moreno, Gabriel, Crespi, Llorenç Socias, Rodriguez-Ruiz, Emilio, Hemang, Yadav

المساهمون: Intensive care medicine, ACS - Atherosclerosis & ischemic syndromes, ACS - Diabetes & metabolism

المصدر: Chest, 158(5), 1947-1957. American College of Chest Physicians
Demoule, A, Antonelli, M, Schellongowski, P, Pickkers, P, Soares, M, Meyhoff, T S, Rello, J, Bauer, P, van de Louw, A, Lemiale, V, Grimaldi, D, Martin-Loeches, I, Balik, M, Mehta, S, Kouatchet, A, Barratt-Due, A, Valkonen, M, Reignier, J, Metaxa, V, Moreau, A S, Burghi, G, Mokart, D, Mayaux, J, Darmon, M, Azoulay, E, Amrein, K, Staundinger, T, Heinz, G, Sengölge, G, Zauner, C, Jaksch, P, Taccone, F S, Meert, A P, Benoît, D, Silva, U V A, Pierre de Moraes, A P, Lishoa, T, Salluh, J, Viana, W, Moralez, G, Correa, T D, Shah, U, Karvunidis, T, Martin, B, Russinova, K, Perner, A, Meyhoff, T S, Jonas, N, Bukan, R B, Moeller, A M, Nielsen, L B, Seguin, A, Chermak, A, Terzi, N, Vinatier, I, Wallet, F, Klouche, K, Platon, L, Gaborit, B, Barbier, F, Pène, F, Rabbat, A, Lemiale, V, N'Yunga, M, Girault, C, Lemaitre, C, Artaud-Macari, E, Bruneel, F, Moreau, A S, Kuitunen, A, Marsh, B, Misericordia, M, Mahon, A M, Cinnella, G, Cotoia, A, Riuniti, O, Montini, L, Spoelstra de Man, A, Landburg, P P, Bergmans, D, Hemelaar, P, Kaufmann, T, Barrat-Due, A, Klepstad, P, Encina, B, Moreno, G, Crespi, L S, Rodriguez-Ruiz, E, Bauer, P & Hemang, Y 2020, ' Respiratory Mechanics and Outcomes in Immunocompromised Patients With ARDS : A Secondary Analysis of the EFRAIM Study ', Chest, vol. 158, no. 5, pp. 1947-1957 . https://doi.org/10.1016/j.chest.2020.05.602Test

مصطلحات موضوعية: Male, Respiratory Distress Syndrome, acute respiratory failure, diagnosis, driving pressure, Middle Aged, Prognosis, plateau pressure, Positive-Pressure Respiration, immunocompromised, Immunocompromised Host, Settore MED/41 - ANESTESIOLOGIA, outcome, Respiratory Mechanics, Tidal Volume, Humans, ARDS, Female, Prospective Studies, Aged, Follow-Up Studies

الوصف: Background: In view of the high mortality rate of immunocompromised patients with ARDS, it is important to identify targets for improvement. Research Question: This study investigated factors associated with mortality in this specific ARDS population, including factors related to respiratory mechanics (plateau pressure [Pplat,rs], compliance [Crs], and driving pressure [ΔPrs]). Study Design and Methods: This study consisted of a predefined secondary analysis of the EFRAIM data. Overall, 789 of 1,611 patients met the Berlin criteria for ARDS, and Pplat,rs, ΔPrs, and Crs were available for 494 patients. A hierarchical model was used to assess factors at ARDS onset independently associated with hospital mortality. Results: Hospital mortality was 56.3%. After adjustment, variables independently associated with hospital mortality included ARDS of undetermined etiology (OR, 1.66; 95% CI, 1.01-2.72), need for vasopressors (OR, 1.91; 95% CI, 1.27-2.88), and need for renal replacement therapy (OR, 2.02; 95% CI, 1.37-2.97). ARDS severity according to the Berlin definition, neutropenia on admission, and the type of underlying disease were not significantly associated with mortality. Before adjustment, higher Pplat,rs, higher ΔPrs, and lower Crs were associated with higher mortality. Addition of each of these individual variables to the final hierarchical model revealed a significant association with mortality: ΔPrs (OR, 1.08; 95% CI, 1.05-1.12), Pplat,rs (OR, 1.07; 95% CI, 1.04-1.11), and Crs (OR, 0.97; 95% CI, 0.95-0.98). Tidal volume was not associated with mortality. Interpretation: In immunocompromised patients with ARDS, respiratory mechanics provide additional prognostic information to predictors of hospital mortality. Studies designed to define lung-protective ventilation guided by these physiological variables may be warranted in this specific population.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=dedup_wf_001::ff23c91462b3b7530d53c6c39ea7010bTest
http://hdl.handle.net/10807/215085Test