학술논문
Temporal changes in the epidemiology, management, and outcome from acute respiratory distress syndrome in European intensive care units: a comparison of two large cohorts
Document Type
Clinical report
Author
Sakr, Yasser; François, Bruno; Solé-Violan, Jordi; Kotfis, Katarzyna; Jaschinski, Ulrich; Estella, Angel; Leone, Marc; Jakob, Stephan M.; Wittebole, Xavier; Fontes, Luis E.; de Melo Gurgel, Miguel; Midega, Thais; Vincent, Jean-Louis; Ranieri, V. Marco; Karth, Georg Delle; Draxler, Volker; Filzwieser, Gottfried; Heindl, Werner; Kellner, Gerhard; Bauer, Thomas; Lenz, Kurt; Rossmann, Edmund; Wiedermann, Christian; Biston, Patrick; Chochrad, Didier; Collin, Vincent; Damas, Pierre; Decruyenaere, Johan; Hoste, Eric; Devriendt, Jacques; Espeel, Benoît; Fraipont, Vincent; Installe, Etienne; Malbrain, Manu; Nollet, Guy; Preiser, Jean-Charles; Raemaekers, Jan; Roman, Alain; Simon, Marc; Spapen, Herbert; Swinnen, Walter; Vallot, Frédéreic; Chytra, Ivan; Dadak, Lukas; Herold, Ivan; Polak, Ferdinand; Sterba, Martin; Bestle, Morten; Espersen, Kurt; Guldager, Henrik; Welling, Karen-Liese; Nyman, Dag; Ruokonen, Esko; Saarinen, Kari; Annane, Djillali; Catogni, Philippe; Colas, Gabriel; Coulomb, François; Dorne, Rene; Garrouste, Maite; Isetta, Christian; Larché, Jérôme; Le Gall, Jean-Roger; Lessire, Henry; Malledant, Yannick; Mateu, Philippe; Ossart, Michel; Payen, Didier; Schlossmacher, Pascal; Timsit, Jean-François; Winnock, Stéphane; Sollet, Jean-Pierre; Mallet, Laurent; Maurer, Peter; Sab, Jean-Michel; Aykut, Gueclue; Brunkhorst, Frank; Nierhaus, Axel; Lauterbach, Michael; Ragaller, Max; Gatz, Rainer; Gerlach, Herwig; Henzler, Deitrich; Hopf, Hand-Bernd; Hueneburg, Hilmar; Karzai, Waheed; Keller, Ansgar; Kuhlmann, Uwe; Langgartner, Julia; Manhold, Cornelia; Reith, B.; Schuerholz, Tobias; Spies, Claudia; Stögbauer, Reimund; Unterburger, J.; Clouva-Molyvdas, Phyllis-Maria; Giokas, George; Ioannidou, Eleni; Lahana, Alexandra; Liolios, Alexandros; Marathias, Katerina; Nakos, George; Tasiou, Antonia; Tsangaris, Hercules; Tamasi, Peter; Marsh, Brian; Power, Michael; Sprung, Charles; Biagioli, Bonizella; Pallavicini, Franco Bobbio; Pesenti, Antonio; Capra, Carlo; Corte, Francesco Della; Donadio, Pierpaulo; Donati, Abele; Giarratano, Antonino; Giorgio, Tulli; Giudici, Daniela; Greco, Stefano; Guadagnucci, Alberto; Lapichino, Gaetano; Livigni, Sergio; Moise, Gabriella; Nardi, Giuseppe; Panascia, Eltore; Pizzamiglio, M.; Ranieri, V. M.; Rosi, Ranieri; Sicignano, Alberto; Solca, Maurizio; Vignali, G.; Rinonapoli, Italo Volpe; Barnas, Michel; De Bel, Ernst E.; De Pont, Anne-Cornelie; Groeneveld, Johan; Nijsten, Maarten; Sie, Liang-Hai; Zandstra, Durk F.; Harboe, Svein; Lindén, Svante; Lovstad, Renata Z.; Moen, Harald; Smith-Erichsen, Nils; Piotrowski, Andrjej; Karpel, Ewa; Almeida, Eduardo; Moreno, Rui; Pais-De-Lacerda, Antonio; Paiva, Jose A.; Serra, Isabel; Pimentel, Jorge M.; Filipescu, Daniela; Jovanovic, Krsta; Malik, Peter; Lucka, Kosec; Voga, Gorazd; Alvarez-Santullano, Cesar Aldecoa; Artigas, Antonio; Zavala, Elizabeth; Escorsell, Angels; Nicolas, Jose; Cea, José JIzura; Marina, Luis; Montejo, Juan; Palencia, Eduardo; Santos, Francisco; Sierra-Camerino, Rafael; Sipmann, Fernando; Brodersen, Keld; Haggqvist, Jan; Hermansson, Dan; Hjelmqvist, Hans; Heer, Kuno; Loderer, Giorgio; Maggiorini, Marco; Zender, Hervé; Andrews, Peter; Appadu, Balraj; Groba, Casiano Barrera; Bewley, Jeremy; Burchett, Ken; Chambers, Philip; Coakley, John; Doberenz, Doris; Eastwood, Nigel; Ferguson, Andrew; Fielden, Jonathan; Gedney, Jacqueline; Gunning, Kevin; Harling, David; Jankowski, Stas; Jayson, David; Kilner, Andrew; Krishna-Kumar, Venketachalam; Lei, K.; Mackenzie, S.; Macnaughton, Peter; Marx, Gernot; McCulloch, C.; Morgan, Paul; Rhodes, Andrew; Roberts, Chris; Russell, Mark; Tupper-Carey, Darell; Wright, Maggie; Twohey, Linda; Watts, James; Webster, Rae; Williams, Dewi; Urbanek, Philipp; Schlieber, Joachim; Reisinger, Johann; Auer, Johann; Hartjes, Andreas; Lerche, Andreas; Janous, Thomas; Kink, Eveline; Krahulec, Walter; Smolle, Karl-Heinz; Van Der Schueren, Marc; Thibo, Patrick; Vanhoof, Marc; Ahmet, Ibis; Gadisseux, Philippe; Dufaye, Philippe; Jacobs, Olivier; Dive, Alain; Bouckaert, Yves; Gilbert, Eric; Gressens, Benjamin; Pinck, Eric; De Waele, Jan J.; Rimachi, Rocio; Gusu, Dan; De Decker, Koen; Mandianga, Kakisidi; Heytens, Luc; Van Collie, Olivier; Vandenheede, Wout; Rogiers, Peter; Pavlik, Pavel; Manak, Jan; Kieslichova, Eva; Turek, Radovan; Fischer, Michal; Valkova, Radka; Dostal, Pavel; Malaska, Jan; Hajek, Roman; Židková, Alexandra; Lavicka, Pavel; Kolodzeike, Piotr; Kruse, Mary; Andersen, Torben; Harjola, Veli-Pekka; Durocher, Alain; Moulront, Serge; Lepape, Alain; Losser, Marie-Reine; Cabaret, Philippe; Kalaitzis, Evangelos; Zogheib, Elie; Charve, Philippe; Lefrant, Jean-Yves; Beilouny, Bassam; Forceville, Xavier; Misset, Benoit; Jacobs, Frederic; Floccard, Bernard; Wynckel, Alain; Castelain, Vincent; Faure, Alexandre; Lavagne, Pierre; Lepoivre, Thierry; Moussa, Mouhamed D.; Vieillard-Baron, Antoine; Durand, Michel; Gainnier, Marc; Ichai, Carole; Arens, Stefan; Hoffmann, Clemens; Kaffarnik, Magnus; Scharnofske, Claus-Jorg; Voigt, Ingo; Peckelsen, Claus; Weber, Matthias; Gille, Jochen; Lange, Andreas; Schoser, Georg; Sablotzki, Armin; Bluethgen, Andreas; Vogel, Frank; Tscheu, Andreas; Fuchs, Thomas; Wattenberg, Michael; Helmes, Torsten; Scieszka, Stefan; Heintz, Matthias; Sakka, Samir; Kohler, Johannes; Fiedler, Fritz; Danz, Matthias; Riessen, Reimer; Kerz, Thomas; Kersten, Alexander; Tacke, Frank; Volkert, Thomas; Schmutz, Axel; Kluge, Stefan; Abel, Peter; Janosi, Rolf A.; Utzolino, Stefan; Bracht, Hendrik; Toussaint, Susanne; Peftoulidou, Maria Giannakou; Myrianthefs, Pavlos; Armaganidis, Apostolos; Routsi, Christina; Xini, Angela; Mouloudi, Eleni; Kokoris, Ioannis; Kyriazopoulos, George; Vlachos, Sawas; Lavrentieva, Athena; Partala, Panagio; Medve, Laszlo; Sarkany, Agnes; Kremer, Ildiko; Marjanek, Zsuzsa; Barry, Joan; O'Leary, Ruth A.; Motherway, Catherine; Faheem, Mohammad; Dunne, Eimhin; Donnelly, Maria; Konrad, Torsten; Cohen, Jonathan; Sold, Oded; Bonora, Eleonora; Achilli, Carola; Rossi, Sandra; Castiglione, Giacomo; Peris, Adriano; Albanese, Daniela; Stocchetti, Nino; Citerio, Giuseppe; Mozzoni, Lorella; Sisillo, Erminio; De Negri, Pasquale; Savioli, Monica; Vecchiarelli, Pietro; Puflea, Florin; Stankovic, Vladimir; Minoja, Giulio; Montibeller, Silvia; Calligaro, Plinio; Sorrentino, Raffaella; Feri, Marco; Zambon, Massimo; Colombaroli, Elena; Pellis, Tommaso; Antonelli, Massimo; Gullo, Antonino; Chelazzi, Cosimo; De Capraris, Antonella; Patroniti, Nicolo; Girardis, Massimo; Franchi, Frederico; Berlot, Giorgio; Ponssen, Hubert; Cate, Julia Ten; Bormans, Laura; Husada, Satria; Buise, Marc; Van Der Hoven, Ben; Reidinga, Auke; Kuiper, Michael; Pickkers, Peter; Kluge, Georg; Boer, Sylvia Den; Kesecioglu, Jozef; Van Leeuwen, Henk; Flaatten, Hans; Mo, Skule; Kolbusz, Julia; Kübler, Andrzej; Mielczarek, Beata; Mikaszewska-Sokolewicz, Malgorzata; Tamowicz, Barbara; Sulkowski, Wiktor; Smuszkiewicz, Piotr; Pihowicz, Andrzej; Trejnowska, Ewa; Branco, Vitor; Rua, Fernando; Lafuente, Estevao; Sousa, Marta; Catorze, Nuno; Barros, Maria; Pereira, Luis; De Oliveira, Ana Vintém; Gomes, Jose; Gaspar, Isable; Pereira, Maria F.; Cymbron, Maria; Dias, Antonio; Beirao, Sofia; Ribeiro, Rosa; Povoa, Pedro; Faria, Filomena; Costa-E-Silva, Zelia; Nóbrega, Jose J.; Fernandes, Fatima; Hagau, Natalia; Droc, Gabriela; Lupu, Mary Nicoleta; Nica, Alexandru; Stoica, Radu; Tomescu, Dana Rodica; Constantinescu, Dacia Laurentia; Zbaganu, Georgica MValcoreanu; Slavcovici, Adriana; Soskic, Ljiljana; Palibrk, Ivan; Jankovic, Radmilo; Jovanovic, Bojan; Pandurovic, Milena; Bumbasirevic, Vesna; Uljarevic, Boris; Surbatovic, Maja; Ladjevic, Nebojsa; Slobodianiuk, Garri; Sobona, Viliam; Cikova, Andrea; Gebhardtova, Andrea; Rupnik, Erik; Kosec, Lucka; PovÅ¡ic, Milena Kerin; Osojnik, Irena; Tomic, Viktorija; González, Javier; Valenzuela, Jesus Pérez; Vidal-Cortés, Pablo; Posada, Pilar; Martin-Loeches, Ignacio; Guillén, Noelia Muéoz; Palomar, Mercedes; Sole-Violan, Jordi; Torres, Antoni; Gallego, Miguel AGonzalez; Aguilar, Gerardo; Allué, Raquel Montoiro; Argüeso, Monica; Parejo, Martin; Navarro, Manuel Palomo; Jose, Anton; Nin, Nicholas; Lerma, Francisco Alvarez; Martinez, Oscar; Lozano, Eva Tenza; López, Sara Arenal; Granda, Maria JPerez; Moreno, Salvador; Llubia, Clara; De La Fuente Martos, Carmen; Gonzalez-Arenas, Paloma; Fernández, Noemi Llamas; Rueda, Bernard Gil; Pons, Isabel Estruch; Cruza, Nieves; Maroto, Fernando; Ferrer, Ana; Fraile, Lisardo Iglesias; Quindos, Brigida; Quintano, Amaia; Tebar, Maria T.; Cardinal, Pablo; Reyes, Antonio; Rodríguez, Alejandro; Abella, Ana; Del Valle, Santiago García; Yus, Santiago; Maseda, Emilio; Berezo, Jose A.; Pedregosa, Armando Tejero; Laplaza, Clara; Ferrer, Ricard; Rico-Feijoo, Jesus; Rodríguez, Marina; Monedero, Pablo; Eriksson, Karin; Chabanel, David; Frankenberger, Bernd; Jakob, Stephan; Matthew, Shiju; Downes, Robert; Johnston, Andrew; Meacher, Roseanne; Keays, Rick; Haji-Michael, Philip; Tyler, Chris; Jones, Simon; Tyl, David; Ball, Andrew; Vogel, John; Booth, Malcolm; Downie, Paul; Watters, Malcolm; Brett, Stephen; Garfield, Marc; Everett, Lynn; Heenen, Sarah; Dhir, Sandeep; Beardow, Zoe; Mostert, Marthinus; Brosnan, Steve; Pinto, Nuno; Harris, Stephen; Summors, Andy; Norton, Andrew; Rose, Alastair; Appelboam, Rebecca; Davies, Omubo; Vickers, Emma; Agarwal, Banwari; Szakmany, Tamas; Wimbush, Stephen; Welters, Ingeborg; Pearse, Rupert; Hollands, Robin; Kirk-Bayley, Justin; Fletcher, Nick; Bray, Barbara; Brealey, David; Alexander, Peter; Henderson, Steven; Hargreaves, Chris; Black, Heather; Gowda, Kiran
Source
Critical Care. February 25, 2021, Vol. 25 Issue 1
Subject
Language
English
ISSN
1364-8535
Abstract
Author(s): Yasser Sakr[sup.1] , Bruno François[sup.2] , Jordi Solé-Violan[sup.3] , Katarzyna Kotfis[sup.4] , Ulrich Jaschinski[sup.5] , Angel Estella[sup.6] , Marc Leone[sup.7] , Stephan M. Jakob[sup.8] , Xavier Wittebole[sup.9] , Luis [...]
Background Mortality rates for patients with ARDS remain high. We assessed temporal changes in the epidemiology and management of ARDS patients requiring invasive mechanical ventilation in European ICUs. We also investigated the association between ventilatory settings and outcome in these patients. Methods This was a post hoc analysis of two cohorts of adult ICU patients admitted between May 1-15, 2002 (SOAP study, n = 3147), and May 8-18, 2012 (ICON audit, n = 4601 admitted to ICUs in the same 24 countries as the SOAP study). ARDS was defined retrospectively using the Berlin definitions. Values of tidal volume, PEEP, plateau pressure, and FiO.sub.2 corresponding to the most abnormal value of arterial PO.sub.2 were recorded prospectively every 24 h. In both studies, patients were followed for outcome until death, hospital discharge or for 60 days. Results The frequency of ARDS requiring mechanical ventilation during the ICU stay was similar in SOAP and ICON (327[10.4%] vs. 494[10.7%], p = 0.793). The diagnosis of ARDS was established at a median of 3 (IQ: 1-7) days after admission in SOAP and 2 (1-6) days in ICON. Within 24 h of diagnosis, ARDS was mild in 244 (29.7%), moderate in 388 (47.3%), and severe in 189 (23.0%) patients. In patients with ARDS, tidal volumes were lower in the later (ICON) than in the earlier (SOAP) cohort. Plateau and driving pressures were also lower in ICON than in SOAP. ICU (134[41.1%] vs 179[36.9%]) and hospital (151[46.2%] vs 212[44.4%]) mortality rates in patients with ARDS were similar in SOAP and ICON. High plateau pressure (> 29 cmH.sub.2O) and driving pressure (> 14 cmH.sub.2O) on the first day of mechanical ventilation but not tidal volume (> 8 ml/kg predicted body weight [PBW]) were independently associated with a higher risk of in-hospital death. Conclusion The frequency of and outcome from ARDS remained relatively stable between 2002 and 2012. Plateau pressure > 29 cmH.sub.2O and driving pressure > 14 cmH.sub.2O on the first day of mechanical ventilation but not tidal volume > 8 ml/kg PBW were independently associated with a higher risk of death. These data highlight the continued burden of ARDS and provide hypothesis-generating data for the design of future studies. Keywords: Respiratory failure, ARDS, Airway pressures, Driving pressure, Tidal volume, Mechanical ventilation
Background Mortality rates for patients with ARDS remain high. We assessed temporal changes in the epidemiology and management of ARDS patients requiring invasive mechanical ventilation in European ICUs. We also investigated the association between ventilatory settings and outcome in these patients. Methods This was a post hoc analysis of two cohorts of adult ICU patients admitted between May 1-15, 2002 (SOAP study, n = 3147), and May 8-18, 2012 (ICON audit, n = 4601 admitted to ICUs in the same 24 countries as the SOAP study). ARDS was defined retrospectively using the Berlin definitions. Values of tidal volume, PEEP, plateau pressure, and FiO.sub.2 corresponding to the most abnormal value of arterial PO.sub.2 were recorded prospectively every 24 h. In both studies, patients were followed for outcome until death, hospital discharge or for 60 days. Results The frequency of ARDS requiring mechanical ventilation during the ICU stay was similar in SOAP and ICON (327[10.4%] vs. 494[10.7%], p = 0.793). The diagnosis of ARDS was established at a median of 3 (IQ: 1-7) days after admission in SOAP and 2 (1-6) days in ICON. Within 24 h of diagnosis, ARDS was mild in 244 (29.7%), moderate in 388 (47.3%), and severe in 189 (23.0%) patients. In patients with ARDS, tidal volumes were lower in the later (ICON) than in the earlier (SOAP) cohort. Plateau and driving pressures were also lower in ICON than in SOAP. ICU (134[41.1%] vs 179[36.9%]) and hospital (151[46.2%] vs 212[44.4%]) mortality rates in patients with ARDS were similar in SOAP and ICON. High plateau pressure (> 29 cmH.sub.2O) and driving pressure (> 14 cmH.sub.2O) on the first day of mechanical ventilation but not tidal volume (> 8 ml/kg predicted body weight [PBW]) were independently associated with a higher risk of in-hospital death. Conclusion The frequency of and outcome from ARDS remained relatively stable between 2002 and 2012. Plateau pressure > 29 cmH.sub.2O and driving pressure > 14 cmH.sub.2O on the first day of mechanical ventilation but not tidal volume > 8 ml/kg PBW were independently associated with a higher risk of death. These data highlight the continued burden of ARDS and provide hypothesis-generating data for the design of future studies. Keywords: Respiratory failure, ARDS, Airway pressures, Driving pressure, Tidal volume, Mechanical ventilation