학술논문
Evolution of Mortality over Time in Patients Receiving Mechanical Ventilation
Document Type
Academic Journal
Author
Esteban, Andrés; Frutos-Vivar, Fernando; Muriel, Alfonso; Ferguson, Niall D.; Peñuelas, Oscar; Abraira, Victor; Raymondos, Konstantinos; Rios, Fernando; Nin, Nicolas; Apezteguía, Carlos; Violi, Damian A.; Thille, Arnaud W.; Brochard, Laurent; González, Marco; Villagomez, Asisclo J.; Hurtado, Javier; Davies, Andrew R.; Du, Bin; Maggiore, Salvatore M.; Pelosi, Paolo; Soto, Luis; Tomicic, Vinko; DʼEmpaire, Gabriel; Matamis, Dimitrios; Abroug, Fekri; Moreno, Rui P.; Soares, Marco Antonio; Arabi, Yaseen; Sandi, Freddy; Jibaja, Manuel; Amin, Pravin; Koh, Younsuck; Kuiper, Michael A.; Bülow, Hans-Henrik; Zeggwagh, Amine Ali; Anzueto, Antonio
Source
American Journal of Respiratory and Critical Care Medicine. Jul 15, 2013 188(2):220-230
Subject
Language
English
ISSN
1073-449X
Abstract
RATIONALE:: OBJECTIVES:: METHODS:: MEASUREMENTS AND MAIN RESULTS:: We included 18,302 patients. The reasons for initiating mechanical ventilation varied significantly among cohorts. Ventilatory management changed over time (P < 0.001), with increased use of noninvasive positive-pressure ventilation (5% in 1998 to 14% in 2010), a decrease in tidal volume (mean 8.8 ml/kg actual body weight [SD = 2.1] in 1998 to 6.9 ml/kg [SD = 1.9] in 2010), and an increase in applied positive end-expiratory pressure (mean 4.2 cm H2O [SD = 3.8] in 1998 to 7.0 cm of H2O [SD = 3.0] in 2010). Crude mortality in the intensive care unit decreased in 2010 compared with 1998 (28 versus 31%; odds ratio, 0.87; 95% confidence interval, 0.80-0.94), despite a similar complication rate. Hospital mortality decreased similarly. After adjusting for baseline and management variables, this difference remained significant (odds ratio, 0.78; 95% confidence interval, 0.67-0.92). CONCLUSIONS:: Clinical trials registered with www.clinicaltrials.gov (NCT01093482).