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Severe Hypercapnia and Outcome of Mechanically Ventilated Patients with Moderate or Severe Acute Respiratory Distress Syndrome

2017-02Journal article Open access
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dc.contributor.authorNin, N
dc.contributor.authorMuriel, A
dc.contributor.authorPeñuelas, O
dc.contributor.authorBrochard, L
dc.contributor.authorLorente, JA
dc.contributor.authorFerguson, N
dc.contributor.authorRaymondos, K
dc.contributor.authorRíos, F
dc.contributor.authorVioli, DA
dc.contributor.authorThille, A
dc.contributor.authorGonzález, M
dc.contributor.authorVillagomez, AJ
dc.contributor.authorHurtado, J
dc.contributor.authorDavies, AR
dc.contributor.authorDu, B
dc.contributor.authorMaggiore, SM
dc.contributor.authorSoto, L
dc.contributor.authorD'Empaire, G
dc.contributor.authorMatamis, D
dc.contributor.authorAbroug, F
dc.contributor.authorMoreno, R
dc.contributor.authorSoares, MA
dc.contributor.authorArabi, Y
dc.contributor.authorSandi, F
dc.contributor.authorJibaja, M
dc.contributor.authorAmin, P
dc.contributor.authorKoh, Y
dc.contributor.authorKuiper, MA
dc.contributor.authorBülow, HH
dc.contributor.authorZeggwagh, AA
dc.contributor.authorAnzueto, A
dc.contributor.authorSznajder, J
dc.contributor.authorEsteban, A
dc.date.accessioned2018-01-23T16:42:44Z
dc.date.available2018-01-23T16:42:44Z
dc.date.issued2017-02
dc.description.abstractPURPOSE: To analyze the relationship between hypercapnia developing within the first 48 h after the start of mechanical ventilation and outcome in patients with acute respiratory distress syndrome (ARDS). PATIENTS AND METHODS: We performed a secondary analysis of three prospective non-interventional cohort studies focusing on ARDS patients from 927 intensive care units (ICUs) in 40 countries. These patients received mechanical ventilation for more than 12 h during 1-month periods in 1998, 2004, and 2010. We used multivariable logistic regression and a propensity score analysis to examine the association between hypercapnia and ICU mortality. MAIN OUTCOMES: We included 1899 patients with ARDS in this study. The relationship between maximum PaCO2 in the first 48 h and mortality suggests higher mortality at or above PaCO2 of ≥50 mmHg. Patients with severe hypercapnia (PaCO2 ≥50 mmHg) had higher complication rates, more organ failures, and worse outcomes. After adjusting for age, SAPS II score, respiratory rate, positive end-expiratory pressure, PaO2/FiO2 ratio, driving pressure, pressure/volume limitation strategy (PLS), corrected minute ventilation, and presence of acidosis, severe hypercapnia was associated with increased risk of ICU mortality [odds ratio (OR) 1.93, 95% confidence interval (CI) 1.32 to 2.81; p = 0.001]. In patients with severe hypercapnia matched for all other variables, ventilation with PLS was associated with higher ICU mortality (OR 1.58, CI 95% 1.04-2.41; p = 0.032). CONCLUSIONS: Severe hypercapnia appears to be independently associated with higher ICU mortality in patients with ARDS.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationIntensive Care Med. 2017 Feb;43(2):200-208pt_PT
dc.identifier.doi10.1007/s00134-016-4611-1pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2855
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.subjectAdultpt_PT
dc.subjectAgedpt_PT
dc.subjectFemalept_PT
dc.subjectHumanspt_PT
dc.subjectHypercapniapt_PT
dc.subjectLogistic Modelspt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectPropensity Scorept_PT
dc.subjectProspective Studiespt_PT
dc.subjectRespiration, Artificialpt_PT
dc.subjectRespiratory Distress Syndrome, Adultpt_PT
dc.subjectSeverity of Illness Indexpt_PT
dc.subjectSimplified Acute Physiology Scorept_PT
dc.subjectTime Factorspt_PT
dc.subjectIntensive Care Unitspt_PT
dc.subjectCHLC UCIpt_PT
dc.titleSevere Hypercapnia and Outcome of Mechanically Ventilated Patients with Moderate or Severe Acute Respiratory Distress Syndromept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage208pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage200pt_PT
oaire.citation.titleIntensive Care Medicinept_PT
oaire.citation.volume43pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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