TY - JOUR
T1 - Association between ventilatory settings and development of acute respiratory distress syndrome in mechanically ventilated patients due to brain injury
AU - VENTILA group
AU - Tejerina, Eva
AU - Pelosi, Paolo
AU - Muriel, Alfonso
AU - Peñuelas, Oscar
AU - Sutherasan, Yuda
AU - Frutos-Vivar, Fernando
AU - Nin, Nicolás
AU - Davies, Andrew R.
AU - Rios, Fernando
AU - Violi, Damian A.
AU - Raymondos, Konstantinos
AU - Hurtado, Javier
AU - González, Marco
AU - Du, Bin
AU - Amin, Pravin
AU - Maggiore, Salvatore M.
AU - Thille, Arnaud W.
AU - Soares, Marco Antonio
AU - Jibaja, Manuel
AU - Villagomez, Asisclo J.
AU - Kuiper, Michael A.
AU - Koh, Younsuck
AU - Moreno, Rui P.
AU - Zeggwagh, Amine Ali
AU - Matamis, Dimitrios
AU - Anzueto, Antonio
AU - Ferguson, Niall D.
AU - Esteban, Andrés
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Purpose In neurologically critically ill patients with mechanical ventilation (MV), the development of acute respiratory distress syndrome (ARDS) is a major contributor to morbidity and mortality, but the role of ventilatory management has been scarcely evaluated. We evaluate the association of tidal volume, level of PEEP and driving pressure with the development of ARDS in a population of patients with brain injury. Materials and methods We performed a secondary analysis of a prospective, observational study on mechanical ventilation. Results We included 986 patients mechanically ventilated due to an acute brain injury (hemorrhagic stroke, ischemic stroke or brain trauma). Incidence of ARDS in this cohort was 3%. Multivariate analysis suggested that driving pressure could be associated with the development of ARDS (odds ratio for unit increment of driving pressure 1.12; confidence interval for 95%: 1.01 to 1.23) whereas we did not observe association for tidal volume (in ml per kg of predicted body weight) or level of PEEP. ARDS was associated with an increase in mortality, longer duration of mechanical ventilation, and longer ICU length of stay. Conclusions In a cohort of brain-injured patients the development of ARDS was not common. Driving pressure was associated with the development of this disease.
AB - Purpose In neurologically critically ill patients with mechanical ventilation (MV), the development of acute respiratory distress syndrome (ARDS) is a major contributor to morbidity and mortality, but the role of ventilatory management has been scarcely evaluated. We evaluate the association of tidal volume, level of PEEP and driving pressure with the development of ARDS in a population of patients with brain injury. Materials and methods We performed a secondary analysis of a prospective, observational study on mechanical ventilation. Results We included 986 patients mechanically ventilated due to an acute brain injury (hemorrhagic stroke, ischemic stroke or brain trauma). Incidence of ARDS in this cohort was 3%. Multivariate analysis suggested that driving pressure could be associated with the development of ARDS (odds ratio for unit increment of driving pressure 1.12; confidence interval for 95%: 1.01 to 1.23) whereas we did not observe association for tidal volume (in ml per kg of predicted body weight) or level of PEEP. ARDS was associated with an increase in mortality, longer duration of mechanical ventilation, and longer ICU length of stay. Conclusions In a cohort of brain-injured patients the development of ARDS was not common. Driving pressure was associated with the development of this disease.
KW - Acute respiratory distress syndrome
KW - Driving pressure
KW - Mechanical ventilation
KW - Neurologic disease
KW - Neurologically critically ill patients
KW - Pulmonary complications
UR - https://www.scopus.com/pages/publications/85007433809
U2 - 10.1016/j.jcrc.2016.11.010
DO - 10.1016/j.jcrc.2016.11.010
M3 - Artículo
C2 - 27914908
AN - SCOPUS:85007433809
SN - 0883-9441
VL - 38
SP - 341
EP - 345
JO - Journal of Critical Care
JF - Journal of Critical Care
ER -