Temporal changes in the epidemiology, management, and outcome from acute respiratory distress syndrome in European intensive care units: a comparison of two large cohorts.
ARDS
Airway pressures
Driving pressure
Mechanical ventilation
Respiratory failure
Tidal volume
Journal
Critical care (London, England)
ISSN: 1466-609X
Titre abrégé: Crit Care
Pays: England
ID NLM: 9801902
Informations de publication
Date de publication:
25 02 2021
25 02 2021
Historique:
received:
10
08
2020
accepted:
27
12
2020
entrez:
26
2
2021
pubmed:
27
2
2021
medline:
7
9
2021
Statut:
epublish
Résumé
Mortality rates for patients with ARDS remain high. We assessed temporal changes in the epidemiology and management of ARDS patients requiring invasive mechanical ventilation in European ICUs. We also investigated the association between ventilatory settings and outcome in these patients. This was a post hoc analysis of two cohorts of adult ICU patients admitted between May 1-15, 2002 (SOAP study, n = 3147), and May 8-18, 2012 (ICON audit, n = 4601 admitted to ICUs in the same 24 countries as the SOAP study). ARDS was defined retrospectively using the Berlin definitions. Values of tidal volume, PEEP, plateau pressure, and FiO The frequency of ARDS requiring mechanical ventilation during the ICU stay was similar in SOAP and ICON (327[10.4%] vs. 494[10.7%], p = 0.793). The diagnosis of ARDS was established at a median of 3 (IQ: 1-7) days after admission in SOAP and 2 (1-6) days in ICON. Within 24 h of diagnosis, ARDS was mild in 244 (29.7%), moderate in 388 (47.3%), and severe in 189 (23.0%) patients. In patients with ARDS, tidal volumes were lower in the later (ICON) than in the earlier (SOAP) cohort. Plateau and driving pressures were also lower in ICON than in SOAP. ICU (134[41.1%] vs 179[36.9%]) and hospital (151[46.2%] vs 212[44.4%]) mortality rates in patients with ARDS were similar in SOAP and ICON. High plateau pressure (> 29 cmH The frequency of and outcome from ARDS remained relatively stable between 2002 and 2012. Plateau pressure > 29 cmH
Sections du résumé
BACKGROUND
Mortality rates for patients with ARDS remain high. We assessed temporal changes in the epidemiology and management of ARDS patients requiring invasive mechanical ventilation in European ICUs. We also investigated the association between ventilatory settings and outcome in these patients.
METHODS
This was a post hoc analysis of two cohorts of adult ICU patients admitted between May 1-15, 2002 (SOAP study, n = 3147), and May 8-18, 2012 (ICON audit, n = 4601 admitted to ICUs in the same 24 countries as the SOAP study). ARDS was defined retrospectively using the Berlin definitions. Values of tidal volume, PEEP, plateau pressure, and FiO
RESULTS
The frequency of ARDS requiring mechanical ventilation during the ICU stay was similar in SOAP and ICON (327[10.4%] vs. 494[10.7%], p = 0.793). The diagnosis of ARDS was established at a median of 3 (IQ: 1-7) days after admission in SOAP and 2 (1-6) days in ICON. Within 24 h of diagnosis, ARDS was mild in 244 (29.7%), moderate in 388 (47.3%), and severe in 189 (23.0%) patients. In patients with ARDS, tidal volumes were lower in the later (ICON) than in the earlier (SOAP) cohort. Plateau and driving pressures were also lower in ICON than in SOAP. ICU (134[41.1%] vs 179[36.9%]) and hospital (151[46.2%] vs 212[44.4%]) mortality rates in patients with ARDS were similar in SOAP and ICON. High plateau pressure (> 29 cmH
CONCLUSION
The frequency of and outcome from ARDS remained relatively stable between 2002 and 2012. Plateau pressure > 29 cmH
Identifiants
pubmed: 33632247
doi: 10.1186/s13054-020-03455-8
pii: 10.1186/s13054-020-03455-8
pmc: PMC7906083
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
87Investigateurs
Georg Delle Karth
(GD)
Volker Draxler
(V)
Gottfried Filzwieser
(G)
Werner Heindl
(W)
Gerhard Kellner
(G)
Thomas Bauer
(T)
Kurt Lenz
(K)
Edmund Rossmann
(E)
Christian Wiedermann
(C)
Patrick Biston
(P)
Didier Chochrad
(D)
Vincent Collin
(V)
Pierre Damas
(P)
Johan Decruyenaere
(J)
Eric Hoste
(E)
Jacques Devriendt
(J)
Benoît Espeel
(B)
Vincent Fraipont
(V)
Etienne Installe
(E)
Manu Malbrain
(M)
Guy Nollet
(G)
Jean-Charles Preiser
(JC)
Jan Raemaekers
(J)
Alain Roman
(A)
Marc Simon
(M)
Herbert Spapen
(H)
Walter Swinnen
(W)
Frédéreic Vallot
(F)
Jean-Louis Vincent
(JL)
Ivan Chytra
(I)
Lukas Dadak
(L)
Ivan Herold
(I)
Ferdinand Polak
(F)
Martin Sterba
(M)
Morten Bestle
(M)
Kurt Espersen
(K)
Henrik Guldager
(H)
Karen-Liese Welling
(KL)
Dag Nyman
(D)
Esko Ruokonen
(E)
Kari Saarinen
(K)
Djillali Annane
(D)
Philippe Catogni
(P)
Gabriel Colas
(G)
François Coulomb
(F)
Rene Dorne
(R)
Maite Garrouste
(M)
Christian Isetta
(C)
Jérôme Larché
(J)
Jean-Roger Le Gall
(JR)
Henry Lessire
(H)
Yannick Malledant
(Y)
Philippe Mateu
(P)
Michel Ossart
(M)
Didier Payen
(D)
Pascal Schlossmacher
(P)
Jean-François Timsit
(JF)
Stéphane Winnock
(S)
Jean-Pierre Sollet
(JP)
Laurent Mallet
(L)
Peter Maurer
(P)
Jean-Michel Sab
(JM)
Gueclue Aykut
(G)
Frank Brunkhorst
(F)
Axel Nierhaus
(A)
Michael Lauterbach
(M)
Max Ragaller
(M)
Rainer Gatz
(R)
Herwig Gerlach
(H)
Deitrich Henzler
(D)
Hand-Bernd Hopf
(HB)
Hilmar Hueneburg
(H)
Waheed Karzai
(W)
Ansgar Keller
(A)
Uwe Kuhlmann
(U)
Julia Langgartner
(J)
Cornelia Manhold
(C)
B Reith
(B)
Tobias Schuerholz
(T)
Claudia Spies
(C)
Reimund Stögbauer
(R)
J Unterburger
(J)
Phyllis-Maria Clouva-Molyvdas
(PM)
George Giokas
(G)
Eleni Ioannidou
(E)
Alexandra Lahana
(A)
Alexandros Liolios
(A)
Katerina Marathias
(K)
George Nakos
(G)
Antonia Tasiou
(A)
Hercules Tsangaris
(H)
Peter Tamasi
(P)
Brian Marsh
(B)
Michael Power
(M)
Charles Sprung
(C)
Bonizella Biagioli
(B)
Franco Bobbio Pallavicini
(FB)
Antonio Pesenti
(A)
Carlo Capra
(C)
Francesco Della Corte
(FD)
Pierpaulo Donadio
(P)
Abele Donati
(A)
Antonino Giarratano
(A)
Tulli Giorgio
(T)
Daniela Giudici
(D)
Stefano Greco
(S)
Alberto Guadagnucci
(A)
Gaetano Lapichino
(G)
Sergio Livigni
(S)
Gabriella Moise
(G)
Giuseppe Nardi
(G)
Eltore Panascia
(E)
M Pizzamiglio
(M)
V M Ranieri
(VM)
Ranieri Rosi
(R)
Alberto Sicignano
(A)
Maurizio Solca
(M)
G Vignali
(G)
Italo Volpe Rinonapoli
(IV)
Michel Barnas
(M)
Ernst E De Bel
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Anne-Cornelie De Pont
(AC)
Johan Groeneveld
(J)
Maarten Nijsten
(M)
Liang-Hai Sie
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(A)
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(JA)
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(P)
Kosec Lucka
(K)
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(G)
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(CA)
Antonio Artigas
(A)
Elizabeth Zavala
(E)
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(J)
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(JJ)
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(L)
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(J)
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(MR)
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(RA)
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(H)
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(MG)
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(L)
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(E)
Pasquale De Negri
(P)
Monica Savioli
(M)
Pietro Vecchiarelli
(P)
Florin Puflea
(F)
Vladimir Stankovic
(V)
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(G)
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(H)
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(J)
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(A)
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(B)
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(M)
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(K)
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(B)
Wiktor Sulkowski
(W)
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(P)
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(A)
Ewa Trejnowska
(E)
Vitor Branco
(V)
Fernando Rua
(F)
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(E)
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(M)
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(N)
Maria Barros
(M)
Luis Pereira
(L)
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(AV)
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Viliam Sobona
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Andrea Cikova
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Andrea Gebhardtova
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Erik Rupnik
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Lucka Kosec
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Milena Kerin Povšic
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Irena Osojnik
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Oscar Martinez
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Amaia Quintano
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Antonio Reyes
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(K)
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