Document Detail

Risk factors for the deterioration of oxygenation ratio in ventilated intensive care unit patients: a retrospective cohort study.
MedLine Citation:
PMID:  19592207     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The aim of the study is to determine which factors are associated with the deterioration of Pao(2)/fraction of inspired oxygen (Fio(2)) ratio in patients with normal oxygenation at admission and ventilated according to a lung protective ventilation strategy. MATERIALS AND METHODS: Retrospective cohort study of ventilated (>/=3 days) intensive care unit patients with an admission Pao(2)/Fio(2) ratio of 300 mm Hg or higher (n = 105). Patients who developed lung injury (Pao(2)/Fio(2) ratio, <300 mm Hg) on day 7 (n = 37) were compared to those who did not (n = 68), with regard to ventilator settings, gas exchange variables, and lung injury risk factors. RESULTS: Mean +/- SD of administered tidal volume was 7.9 +/- 1.3 mL/kg. Patients who developed lung injury were older (P = .019), had lower Pao(2) (P = .009), higher Paco(2) (P = .045), and lower Pao(2)/Fio(2) ratio (P = .002) at admission. Postoperative state (Hazard risk [HR], 5.1) and controlled ventilation mode (HR, 4.3) were identified as independent risk factors. Lung injury-free time was shorter in patients with low initial Pao(2)/Fio(2) ratio (odds ratio, 1.7; P = .039). This effect was not only caused by the baseline difference, as the decrease in Pao(2)/Fio(2) ratio was more pronounced in patients who developed lung injury compared to those who did not (P = .008). CONCLUSIONS: Lung injury exacerbates during mechanical ventilation. In patients treated with a mean tidal volume of 7.9 mL/kg, controlled ventilation is a major risk factor.
Ilma W F Fick; Myrthe M Tijdink; Feico J J Halbertsma; Johannes G van der Hoeven; Peter Pickkers
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Publication Detail:
Type:  Journal Article     Date:  2009-07-09
Journal Detail:
Title:  Journal of critical care     Volume:  25     ISSN:  1557-8615     ISO Abbreviation:  J Crit Care     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-01     Completed Date:  2010-04-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3-9     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Radboud University Nijmegen Medical Center, PO-Box 9101, 6500HB Nijmegen, The Netherlands.
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MeSH Terms
Cohort Studies
Intensive Care Units
Lung Injury / etiology*
Middle Aged
Oxygen / metabolism*
Oxygen Consumption
Respiration, Artificial / adverse effects*
Retrospective Studies
Risk Factors
Tidal Volume
Treatment Outcome
Reg. No./Substance:

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