| Incidence, risk factors and outcome of barotrauma in mechanically ventilated patients. | |
| | |
MedLine Citation:
|
PMID: 14991090 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To determine the incidence, risk factors, and outcome of barotrauma in a cohort of mechanically ventilated patients where limited tidal volumes and airway pressures were used. DESIGN AND SETTING: Prospective cohort of 361 intensive care units from 20 countries. PATIENTS AND PARTICIPANTS: A total of 5183 patients mechanically ventilated for more than 12 h. MEASUREMENTS AND RESULTS: Baseline demographic data, primary indication for mechanical ventilation, daily ventilator settings, multiple-organ failure over the course of mechanical ventilation and outcome were collected. Barotrauma was present in 154 patients (2.9%). The incidence varied according to the reason for mechanical ventilation: 2.9% of patients with chronic obstructive pulmonary disease; 6.3% of patients with asthma; 10.0% of patients with chronic interstitial lung disease (ILD); 6.5% of patients with acute respiratory distress syndrome (ARDS); and 4.2% of patients with pneumonia. Patients with and without barotrauma did not differ in any ventilator parameter. Logistic regression analysis identified as factors independently associated with barotrauma: asthma [RR 2.58 (1.05-6.50)], ILD [RR 4.23 (95%CI 1.78-10.03)]; ARDS as primary reason for mechanical ventilation [RR 2.70 (95%CI 1.55-4.70)]; and ARDS as a complication during the course of mechanical ventilation [RR 2.53 (95%CI 1.40-4.57)]. Case-control analysis showed increased mortality in patients with barotrauma (51.4 vs 39.2%; p=0.04) and prolonged ICU stay. CONCLUSIONS: In a cohort of patients in whom airway pressures and tidal volume are limited, barotrauma is more likely in patients ventilated due to underlying lung disease (acute or chronic). Barotrauma was also associated with a significant increase in the ICU length of stay and mortality. |
| | |
Authors:
|
Antonio Anzueto; Fernando Frutos-Vivar; Andres Esteban; Inmaculada Alía; Laurent Brochard; Thomas Stewart; Salvador Benito; Martin J Tobin; Jose Elizalde; Fernando Palizas; Cide M David; Jorge Pimentel; Marco González; Luis Soto; Gabriel D'Empaire; Paolo Pelosi |
Publication Detail:
|
Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2004-02-28 |
Journal Detail:
|
Title: Intensive care medicine Volume: 30 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 2004 Apr |
Date Detail:
|
Created Date: 2004-03-31 Completed Date: 2004-10-21 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
|
Languages: eng Pagination: 612-9 Citation Subset: IM |
Affiliation:
|
Department of Medicine, Division of Pulmonary /Critical Care Medicine, University of Texas Health Science Center and South Texas Veterans Health Care System, Audie L. Murphy Memorial Veterans Hospital Division, San Antonio, TX USA. anzueto@uthscsa.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Asthma / pathology, therapy Barotrauma / etiology*, mortality, therapy Cohort Studies Female Humans Incidence Intensive Care Units Lung / pathology* Male Middle Aged Prognosis Prospective Studies Pulmonary Disease, Chronic Obstructive / pathology, therapy Respiration, Artificial / adverse effects* Respiratory Distress Syndrome, Adult / pathology, therapy Risk Factors Survival Rate |
| Comments/Corrections | |
Comment In:
|
Intensive Care Med. 2004 Apr;30(4):533-5
[PMID:
14985954
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Can the impact of bed closure in intensive care units be reliably monitored?
Next Document: Increased levels of soluble ST2 protein and IgG1 production in patients with sepsis and trauma.