Comparison of efficacy of different ventilators to administer NIV in healthy subjects

Critical Care, Mar 2002

S Chatterjee, GD Perkins, S Giles, D McAuley, M Roland

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Comparison of efficacy of different ventilators to administer NIV in healthy subjects

BioMed Central Ltd (Print 1364-8535 22nd International Symposium on Intensive Care and Emergency Medicine 0 FS Dias, N Almeida, IC Wawrzeniack, PB Nery Hospital Sao Lucas da PUCRS , Av. Ipiranga 6690, CEP 90610-000 Porto Alegre, RS , Brazil 1 FS Dias, N Almeida, IC Wawrzeniack, PB Nery, JA Froemming, MO Guerreiro Hospital Sao Lucas da PUCRS , Av. Ipiranga 6690, CEP 90610-000 Porto Alegre, RS , Brazil 2 T Simpson, EF Bond University of Washington School of Nursing, Biobehavioral Nursing & Health Systems Department , Box 357266, Seattle, WA 98195-7266 , USA 3 T Schreiber, K Schwarzkopf, B Schmidt, W Karzai Department of Anesthesiology and Intensive Care Medicine, University of Jena , Bachstrasse 18, 07740 Jena , Germany 4 Y Tur, GM Koksal, C Sayilgan, H Oz IU Cerrahpacsa Medical Faculty, Department of Anaesthesiology , 34303 Istanbul , Turkey 5 RR Gubaidullin, AV Butrov Medical Faculty of Russian Peoples' Friendship University , Tsyurupy 16-1-168, 117418 Moscow , Russia 6 HB Qiu, Y Tan, SX Zhou, FM Guo, JH Dai Department of Critical Care Medicine (ICU), Zhong-Da Hospital and Clinical Medical College, Southeast University , Nanjing , PR China 7 E Huettemann, M Steinecke, C Schelenz, S Thomas, K Reinhart Department of Anaesthesiology and Intensive Care, Friedrich-Schiller-University , D-07740 Jena , Germany 8 J Reutershan, A Schmitt, R Fretschner Department of Anaesthesiology and Critical Care, University Hospital Tubingen , Hoppe-Seyler-Str. 3, 72076 Tubingen , Germany 9 SJ Claesson, S Lehtipalo, O Winso Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care, Umea University Hospital , S-901 85 Umea , Sweden 10 JC Lewejohann, E Rieh, E Muhl, HP Bruch Department of Surgery, Medical University of Lubeck , Ratzeburger Allee 160, 23538 Lubeck , Germany 11 MG Baacke, T Neubert, M Spies, L Gotzen, RJ Stiletto Department of Trauma-Surgery and Intensive-Care of the Philipps-University-Marburg , Germany 12 MG Baacke, I Roth, RJ Stiletto, M Rothmund, L Gotzen Department of Trauma-Surgery and Intensive-Care of the Philipps-University-Marburg , Germany 13 ScF Kahveci, N Kelebek , B Yavacscao g Purpose: To describe the epidemiology of the acute respiratory distress syndrome (ARDS) in a Brazilian ICU. Methods: This prospective observational, non-interventional study, included all consecutive patients with ARDS criteria [1] admitted in the ICU of a Brazilian tertiary hospital, between January 1997 and September 2001. Were collected in a prospective fashion the following variables: age, gender, APACHE II score at ICU admission and at ARDS diagnosis, cause of ARDS, presence of AIDS, cancer and immunosuppression, occurrence of barotrauma, performance of traqueostomy, mortality, duration of mechanical ventilation (MV), length of stay (LOS) in ICU and in hospital. The lung injury score (LIS) [2] was used to quantify the degree of pulmonary injury in the first week of ARDS. - Epidemiology of ARDS in a Brazilian ICU Results: There was 2182 patients (P) admitted in ICU during the study period, of whom 141 (6.46%) had ARDS criteria. Seventy-six (54%) were men, the mean age was 46 18 years, APACHE II 18 7 and 19 7 at admission and at ARDS diagnosis, respectively. Septic shock accounted for 42% (60 P) of the ARDS causes, sepsis 22% (31 P), diffuse pulmonary infection 16% (23 P), aspiration pneumonia 11% (15 P), non-septic shock 5% (7 P) and others 4% (5 P). Ten percent (14 P) had AIDS, 30% (43 P) cancer and 25% (36 P) immunosuppression. All patients were mechanically ventilated with Tidal Volume between 4 and 8 ml/kg. Only 3.5% (5 P) had barotrauma and 10% (14 P) performed traqueostomy. Mortality rate was 79% in the ICU. The patients required 12 10 days on MV, ranging from 1 to 55 days. The LOS in ICU and hospital was 14 13 (169) days and 28 32 (1325) days, respectively. There was a time delay of 3.7 4.5 days between admission in ICU and the onset of ARDS. The Murray score (mean SD) was 3.2 0.4, 3 0.5, 3 0.5, 2.9 0.6, 2.8 0.7, 2.7 0.7 and 2.6 0.8 in the first 7 days, respectively. Conclusions: ARDS in our hospital has a similar incidence of reports in the USA and Europe. There was a higher mortality, which could be explained by a high incidence of infection causes of ARDS, mainly septic shock, and elevated combined occurrence of AIDS, cancer and immunosuppression, along the degree of LIS. The incidence of barotrauma was low, as a consequence of the current mechanical ventilation strategies. Role of multiple organ dysfunction syndrome in ARDS mortality Methods: This cohort study includes all consecutive patients with ARDS criteria [1] admitted in the ICU between January 1997 and September 2001. Were collected in a prospective fashion the following variables: age, gender, APACHE II score at the ARDS diagnosis, the occurrence of organ dysfunction determined by the multiple organ dysfunction syndrome (MODS) [2] in the first week, and mortality in the ICU. The occurrence of organ/syste (...truncated)


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S Chatterjee, GD Perkins, S Giles, D McAuley, M Roland. Comparison of efficacy of different ventilators to administer NIV in healthy subjects, Critical Care, 2002, pp. P43, 6,