Resolved versus confirmed ARDS after 24 h: insights from the LUNG SAFE study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00843989%3A_____%2F18%3AE0107122" target="_blank" >RIV/00843989:_____/18:E0107122 - isvavai.cz</a>

Result on the web

<a href="http://dx.doi.org/10.1007/s00134-018-5152-6" target="_blank" >http://dx.doi.org/10.1007/s00134-018-5152-6</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s00134-018-5152-6" target="_blank" >10.1007/s00134-018-5152-6</a>

Result language

angličtina

Original language name

Resolved versus confirmed ARDS after 24 h: insights from the LUNG SAFE study

Original language description

PURPOSE: To evaluate patients with resolved versus confirmed ARDS, identify subgroups with substantial mortality risk, and to determine the utility of day 2 ARDS reclassification. METHODS: Our primary objective, in this secondary LUNG SAFE analysis, was to compare outcome in patients with resolved versus confirmed ARDS after 24 h. Secondary objectives included identifying factors associated with ARDS persistence and mortality, and the utility of day 2 ARDS reclassification. RESULTS: Of 2377 patients fulfilling the ARDS definition on the first day of ARDS (day 1) and receiving invasive mechanical ventilation, 503 (24%) no longer fulfilled the ARDS definition the next day, 52% of whom initially had moderate or severe ARDS. Higher tidal volume on day 1 of ARDS was associated with confirmed ARDS [OR 1.07 (CI 1.01-1.13), P = 0.035]. Hospital mortality was 38% overall, ranging from 31% in resolved ARDS to 41% in confirmed ARDS, and 57% in confirmed severe ARDS at day 2. In both resolved and confirmed ARDS, age, non-respiratory SOFA score, lower PEEP and P/F ratio, higher peak pressure and respiratory rate were each associated with mortality. In confirmed ARDS, pH and the presence of immunosuppression or neoplasm were also associated with mortality. The increase in area under the receiver operating curve for ARDS reclassification on day 2 was marginal. CONCLUSIONS: ARDS, whether resolved or confirmed at day 2, has a high mortality rate. ARDS reclassification at day 2 has limited predictive value for mortality. The substantial mortality risk in severe confirmed ARDS suggests that complex interventions might best be tested in this population.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30221 - Critical care medicine and Emergency medicine

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2018

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Intensive Care Medicine

ISSN

0342-4642

e-ISSN

1432-1238

Volume of the periodical

44

Issue of the periodical within the volume

5

Country of publishing house

US - UNITED STATES

Number of pages

14

Pages from-to

564-577

UT code for WoS article

000435589800003

EID of the result in the Scopus database

2-s2.0-85045095335