| Title: |
Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome |
| Authors: |
Nin, Nicolas; Muriel, Alfonso; Peñuelas, Oscar; Brochard, Laurent; Lorente, José Angel; Ferguson, Niall D.; Raymondos, Konstantinos; Ríos, Fernando; Violi, Damian A.; Thille, Arnaud W.; González, Marco; Villagomez, Asisclo J.; Hurtado, Javier; Davies, Andrew R.; Du, Bin; MAGGIORE, Salvatore Maurizio; Soto, Luis; D’Empaire, Gabriel; Matamis, Dimitrios; Abroug, Fekri; Moreno, Rui P.; Soares, Marco Antonio; Arabi, Yaseen; Sandi, Freddy; Jibaja, Manuel; Amin, Pravin; Koh, Younsuck; Kuiper, Michael A.; Bülow, Hans Henrik; Zeggwagh, Amine Ali; Anzueto, Antonio; Sznajder, Jacob I.; Esteban, Andres; for the VENTILA Group, Null |
| Contributors: |
Nin, Nicola; Muriel, Alfonso; Peñuelas, Oscar; Brochard, Laurent; Lorente, José Angel; Ferguson, Niall D.; Raymondos, Konstantino; Ríos, Fernando; Violi, Damian A.; Thille, Arnaud W.; González, Marco; Villagomez, Asisclo J.; Hurtado, Javier; Davies, Andrew R.; Du, Bin; Maggiore, Salvatore Maurizio; Soto, Lui; D’Empaire, Gabriel; Matamis, Dimitrio; Abroug, Fekri; Moreno, Rui P.; Soares, Marco Antonio; Arabi, Yaseen; Sandi, Freddy; Jibaja, Manuel; Amin, Pravin; Koh, Younsuck; Kuiper, Michael A.; Bülow, Hans Henrik; Zeggwagh, Amine Ali; Anzueto, Antonio; Sznajder, Jacob I.; Esteban, Andre; for the VENTILA Group, Null |
| Publication Year: |
2017 |
| Collection: |
ARUd'A - Archivio Istituzionale della ricerca dell'università Chieti-Pescara (IRIS) |
| Subject Terms: |
Acute respiratory distress syndrome; Hypercapnia; ICU mortality; Mechanical ventilation; Critical Care and Intensive Care Medicine |
| Description: |
PURPOSE: To analyze the relationship between hypercapnia developing within the first 48h after the start of mechanical ventilation and outcome in patients with acute respiratory distress syndrome (ARDS). PATIENTS AND METHODS: We performed a secondary analysis of three prospective non-interventional cohort studies focusing on ARDS patients from 927 intensive care units (ICUs) in 40 countries. These patients received mechanical ventilation for more than 12h during 1-month periods in 1998, 2004, and 2010. We used multivariable logistic regression and a propensity score analysis to examine the association between hypercapnia and ICU mortality. MAIN OUTCOMES: We included 1899 patients with ARDS in this study. The relationship between maximum PaCO2 in the first 48h and mortality suggests higher mortality at or above PaCO2 of ≥50mmHg. Patients with severe hypercapnia (PaCO2 ≥50mmHg) had higher complication rates, more organ failures, and worse outcomes. After adjusting for age, SAPS II score, respiratory rate, positive end-expiratory pressure, PaO2/FiO2 ratio, driving pressure, pressure/volume limitation strategy (PLS), corrected minute ventilation, and presence of acidosis, severe hypercapnia was associated with increased risk of ICU mortality [odds ratio (OR) 1.93, 95% confidence interval (CI) 1.32 to 2.81; p=0.001]. In patients with severe hypercapnia matched for all other variables, ventilation with PLS was associated with higher ICU mortality (OR 1.58, CI 95% 1.04-2.41; p=0.032). CONCLUSIONS: Severe hypercapnia appears to be independently associated with higher ICU mortality in patients with ARDS. TRIAL REGISTRATION: Clinicaltrials.gov identifier, NCT01093482. |
| Document Type: |
article in journal/newspaper |
| File Description: |
STAMPA |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/28108768; info:eu-repo/semantics/altIdentifier/wos/WOS:000394320900005; volume:43; issue:2; firstpage:200; lastpage:208; numberofpages:9; journal:INTENSIVE CARE MEDICINE; https://hdl.handle.net/11564/668440 |
| DOI: |
10.1007/s00134-016-4611-1 |
| Availability: |
https://hdl.handle.net/11564/668440; https://doi.org/10.1007/s00134-016-4611-1; https://link.springer.com/article/10.1007/s00134-016-4611-1 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.A48C37D5 |
| Database: |
BASE |