Serpa Neto, Ary and Schmidt, Matthieu and Azevedo, Luciano C. P. and Bein, Thomas and Brochard, Laurent and Beutel, Gernot and Combes, Alain and Costa, Eduardo L. V. and Hodgson, Carol and Lindskov, Christian and Lubnow, Matthias and Lueck, Catherina and Michaels, Andrew J. and Paiva, Jose-Artur and Park, Marcelo and Pesenti, Antonio and Pham, Tai and Quintel, Michael and Marco Ranieri, V. and Ried, Michael and Roncon-Albuquerque, Roberto and Slutsky, Arthur S. and Takeda, Shinhiro and Terragni, Pier Paolo and Vejen, Marie and Weber-Carstens, Steffen and Welte, Tobias and Gama de Abreu, Marcelo and Pelosi, Paolo and Schultz, Marcus J. (2016) Associations between ventilator settings during extracorporeal membrane oxygenation for refractory hypoxemia and outcome in patients with acute respiratory distress syndrome: a pooled individual patient data analysis. INTENSIVE CARE MEDICINE, 42 (11). pp. 1672-1684. ISSN 0342-4642, 1432-1238
Full text not available from this repository. (Request a copy)Abstract
Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for patients with acute respiratory distress syndrome (ARDS). The aim of this study was to evaluate associations between ventilatory settings during ECMO for refractory hypoxemia and outcome in ARDS patients. In this individual patient data meta-analysis of observational studies in adult ARDS patients receiving ECMO for refractory hypoxemia, a time-dependent frailty model was used to determine which ventilator settings in the first 3 days of ECMO had an independent association with in-hospital mortality. Nine studies including 545 patients were included. Initiation of ECMO was accompanied by significant decreases in tidal volume size, positive end-expiratory pressure (PEEP), plateau pressure, and driving pressure (plateau pressure - PEEP) levels, and respiratory rate and minute ventilation, and resulted in higher PaO2/FiO(2), higher arterial pH and lower PaCO2 levels. Higher age, male gender and lower body mass index were independently associated with mortality. Driving pressure was the only ventilatory parameter during ECMO that showed an independent association with in-hospital mortality [adjusted HR, 1.06 (95 % CI, 1.03-1.10)]. In this series of ARDS patients receiving ECMO for refractory hypoxemia, driving pressure during ECMO was the only ventilator setting that showed an independent association with in-hospital mortality.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | MECHANICAL VENTILATION; PROTECTIVE VENTILATION; PREDICTING SURVIVAL; DRIVING PRESSURE; CRITICAL ILLNESS; MORTALITY RISK; ADULT PATIENTS; LIFE-SUPPORT; LUNG INJURY; 6 ML/KG; Mechanical ventilation; ARDS; Refractory hypoxemia; ECMO; PEEP; Driving pressure |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Abteilung für Thoraxchirurgie Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 24 Apr 2019 09:09 |
| Last Modified: | 24 Apr 2019 09:09 |
| URI: | https://pred.uni-regensburg.de/id/eprint/4040 |
Actions (login required)
 |
View Item |
