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Article Dans Une Revue Annals of Intensive Care Année : 2018

Potentially modifiable respiratory variables contributing to outcome in ICU patients without ARDS: a secondary analysis of PRoVENT

Fabienne Simonis
  • Fonction : Auteur
Carmen Barbas
  • Fonction : Auteur
Antonio Artigas-Raventós
  • Fonction : Auteur
Jaume Canet
  • Fonction : Auteur
Rogier Determann
  • Fonction : Auteur
James Anstey
  • Fonction : Auteur
Sabrine Hemmes
  • Fonction : Auteur
Greet Hermans
  • Fonction : Auteur
Markus Hollmann
  • Fonction : Auteur
Gary Mills
  • Fonction : Auteur
Christian Putensen
  • Fonction : Auteur
Werner Schmid
  • Fonction : Auteur
Paolo Severgnini
  • Fonction : Auteur
Roger Smith
  • Fonction : Auteur
Tanja Treschan
  • Fonction : Auteur
Edda Tschernko
  • Fonction : Auteur
Marcos Vidal Melo
  • Fonction : Auteur
Hermann Wrigge
  • Fonction : Auteur
Marcelo Gama de Abreu
  • Fonction : Auteur
Paolo Pelosi
  • Fonction : Auteur
Marcus Schultz
  • Fonction : Auteur
Ary Serpa Neto
  • Fonction : Auteur

Résumé

Background: The majority of critically ill patients do not suffer from acute respiratory distress syndrome (ARDS). To improve the treatment of these patients, we aimed to identify potentially modifiable factors associated with outcome of these patients. Methods: The PRoVENT was an international, multicenter, prospective cohort study of consecutive patients under invasive mechanical ventilatory support. A predefined secondary analysis was to examine factors associated with mortality. The primary endpoint was all-cause in-hospital mortality. Results: 935 Patients were included. In-hospital mortality was 21%. Compared to patients who died, patients who survived had a lower risk of ARDS according to the ‘Lung Injury Prediction Score’ and received lower maximum airway pressure (Pmax), driving pressure (ΔP), positive end-expiratory pressure, and FiO2 levels. Tidal volume size was similar between the groups. Higher Pmax was a potentially modifiable ventilatory variable associated with in-hospital mortality in multivariable analyses. ΔP was not independently associated with in-hospital mortality, but reliable values for ΔP were available for 343 patients only. Non-modifiable factors associated with in-hospital mortality were older age, presence of immunosuppression, higher non-pulmonary sequential organ failure assessment scores, lower pulse oximetry readings, higher heart rates, and functional dependence. Conclusions: Higher Pmax was independently associated with higher in-hospital mortality in mechanically ventilated critically ill patients under mechanical ventilatory support for reasons other than ARDS.
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hal-01799005 , version 1 (09-05-2020)

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Fabienne Simonis, Carmen Barbas, Antonio Artigas-Raventós, Jaume Canet, Rogier Determann, et al.. Potentially modifiable respiratory variables contributing to outcome in ICU patients without ARDS: a secondary analysis of PRoVENT. Annals of Intensive Care, 2018, 8, pp.39. ⟨10.1186/s13613-018-0385-7⟩. ⟨hal-01799005⟩
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