Evolution of Mortality over Time in Patients Receiving Mechanical Ventilation
Identifieur interne : 004F63 ( Main/Exploration ); précédent : 004F62; suivant : 004F64Evolution of Mortality over Time in Patients Receiving Mechanical Ventilation
Auteurs : Andrés Esteban [Espagne] ; Fernando Frutos-Vivar [Espagne] ; Alfonso Muriel [Espagne] ; Niall D. Ferguson [Canada] ; Oscar Pe Uelas [Espagne] ; Victor Abraira [Espagne] ; Konstantinos Raymondos [Allemagne] ; Fernando Rios [Argentine] ; Nicolas Nin [Espagne] ; Carlos Apezteguia [Argentine] ; Damian A. Violi [Argentine] ; Arnaud W. Thille [France] ; Laurent Brochard [Suisse] ; Marco González [Colombie] ; Asisclo J. Villagomez [Mexique] ; Javier Hurtado [Uruguay] ; Andrew R. Davies [Australie] ; BIN DU [République populaire de Chine] ; Salvatore M. Maggiore [Italie] ; Paolo Pelosi [Italie] ; Luis Soto [Chili] ; Vinko Tomicic [Chili] ; Gabriel D'Empaire [Venezuela] ; Dimitrios Matamis [Grèce] ; Fekri Abroug [Tunisie] ; Rui P. Moreno [Portugal] ; Marco Antonio Soares [Brésil] ; Yaseen Arabi [Arabie saoudite] ; Freddy Sandi [Bolivie] ; Manuel Jibaja [Équateur] ; Pravin Amin ; YOUNSUCK KOH ; Michael A. Kuiper ; Hans-Henrik Bülow ; Amine Ali Zeggwagh ; Antonio AnzuetoSource :
- American journal of respiratory and critical care medicine [ 1073-449X ] ; 2013.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Mortalité, Homme, Santé publique.
English descriptors
- KwdEn :
Abstract
Rationale: Baseline characteristics and management have changed overtime in patients requiring mechanical ventilation; however, the impact of these changes on patient outcomes is unclear. Objectives: To estimate whether mortality in mechanically ventilated patients has changed overtime. Methods: Prospective cohort studies conducted in 1998, 2004, and 2010, including patients receiving mechanical ventilation for more than 12 hours in a 1-month period, from 927 units in 40 countries. To examine effects over time on mortality in intensive care units, we performed generalized estimating equation models. 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: Patient characteristics and ventilation practices have changed overtime, and outcomes of mechanically ventilated patients have improved.
Affiliations:
- Allemagne, Arabie saoudite, Argentine, Australie, Bolivie, Brésil, Canada, Chili, Colombie, Espagne, France, Grèce, Italie, Mexique, Portugal, République populaire de Chine, Suisse, Tunisie, Uruguay, Venezuela, Équateur
- Latium, Minas Gerais, Ontario, Victoria (État), Île-de-France
- Belo Horizonte, Créteil, Melbourne, Pékin, Rome, Toronto
- Université de Toronto
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Villagomez</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Hospital Regional 1° de Octubre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado</s1><s2>México DF</s2><s3>MEX</s3><sZ>15 aut.</sZ></inist:fA14><country>Mexique</country><wicri:noRegion>México DF</wicri:noRegion></affiliation></author><author><name sortKey="Hurtado, Javier" sort="Hurtado, Javier" uniqKey="Hurtado J" first="Javier" last="Hurtado">Javier Hurtado</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Hospital de Clínicas de Montevideo</s1><s3>URY</s3><sZ>16 aut.</sZ></inist:fA14><country>Uruguay</country><wicri:noRegion>Hospital de Clínicas de Montevideo</wicri:noRegion></affiliation></author><author><name sortKey="Davies, Andrew R" sort="Davies, Andrew R" uniqKey="Davies A" first="Andrew R." last="Davies">Andrew R. Davies</name><affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Alfred Hospital & Monash University</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>17 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Bin Du" sort="Bin Du" uniqKey="Bin Du" last="Bin Du">BIN DU</name><affiliation wicri:level="3"><inist:fA14 i1="13"><s1>Peking Union Medical College Hospital</s1><s2>Beijing</s2><s3>CHN</s3><sZ>18 aut.</sZ></inist:fA14><country>République populaire de Chine</country><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Maggiore, Salvatore M" sort="Maggiore, Salvatore M" uniqKey="Maggiore S" first="Salvatore M." last="Maggiore">Salvatore M. Maggiore</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Policlinico "Agostino Gemelli," Università Cattolica Del Sacro Cuore</s1><s2>Roma</s2><s3>ITA</s3><sZ>19 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Pelosi, Paolo" sort="Pelosi, Paolo" uniqKey="Pelosi P" first="Paolo" last="Pelosi">Paolo Pelosi</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Universita' degli Studi</s1><s2>Genoa</s2><s3>ITA</s3><sZ>20 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Genoa</wicri:noRegion></affiliation></author><author><name sortKey="Soto, Luis" sort="Soto, Luis" uniqKey="Soto L" first="Luis" last="Soto">Luis Soto</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>Instituto Nacional del Tórax de Santiago</s1><s3>CHL</s3><sZ>21 aut.</sZ></inist:fA14><country>Chili</country><wicri:noRegion>Instituto Nacional del Tórax de Santiago</wicri:noRegion></affiliation></author><author><name sortKey="Tomicic, Vinko" sort="Tomicic, Vinko" uniqKey="Tomicic V" first="Vinko" last="Tomicic">Vinko Tomicic</name><affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Clínica Las Lilas de Santiago</s1><s3>CHL</s3><sZ>22 aut.</sZ></inist:fA14><country>Chili</country><wicri:noRegion>Clínica Las Lilas de Santiago</wicri:noRegion></affiliation></author><author><name sortKey="D Empaire, Gabriel" sort="D Empaire, Gabriel" uniqKey="D Empaire G" first="Gabriel" last="D'Empaire">Gabriel D'Empaire</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Hospital de Clínicas de Caracas</s1><s3>VEN</s3><sZ>23 aut.</sZ></inist:fA14><country>Venezuela</country><wicri:noRegion>Hospital de Clínicas de Caracas</wicri:noRegion></affiliation></author><author><name sortKey="Matamis, Dimitrios" sort="Matamis, Dimitrios" uniqKey="Matamis D" first="Dimitrios" last="Matamis">Dimitrios Matamis</name><affiliation wicri:level="1"><inist:fA14 i1="19"><s1>Papageorgiou Hospital</s1><s2>Thessaloniki</s2><s3>GRC</s3><sZ>24 aut.</sZ></inist:fA14><country>Grèce</country><wicri:noRegion>Papageorgiou Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Abroug, Fekri" sort="Abroug, Fekri" uniqKey="Abroug F" first="Fekri" last="Abroug">Fekri Abroug</name><affiliation wicri:level="1"><inist:fA14 i1="20"><s1>Hospital Fattouma Bourguina</s1><s2>Monastir</s2><s3>TUN</s3><sZ>25 aut.</sZ></inist:fA14><country>Tunisie</country><wicri:noRegion>Hospital Fattouma Bourguina</wicri:noRegion></affiliation></author><author><name sortKey="Moreno, Rui P" sort="Moreno, Rui P" uniqKey="Moreno R" first="Rui P." last="Moreno">Rui P. Moreno</name><affiliation wicri:level="1"><inist:fA14 i1="21"><s1>Unidade de Cuidados Intensivos Neurocriticos, Hospital de São José, Centro Hospitalar de Lisboa Central</s1><s2>Lisbon</s2><s3>PRT</s3><sZ>26 aut.</sZ></inist:fA14><country>Portugal</country><wicri:noRegion>Lisbon</wicri:noRegion></affiliation></author><author><name sortKey="Soares, Marco Antonio" sort="Soares, Marco Antonio" uniqKey="Soares M" first="Marco Antonio" last="Soares">Marco Antonio Soares</name><affiliation wicri:level="3"><inist:fA14 i1="22"><s1>Hospital Universitário São José</s1><s2>Belo Horizonte</s2><s3>BRA</s3><sZ>27 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">Belo Horizonte</settlement><region type="state">Minas Gerais</region></placeName></affiliation></author><author><name sortKey="Arabi, Yaseen" sort="Arabi, Yaseen" uniqKey="Arabi Y" first="Yaseen" last="Arabi">Yaseen Arabi</name><affiliation wicri:level="1"><inist:fA14 i1="23"><s1>King Saud Bin Abdulaziz University for Health Sciences</s1><s2>Riyadh</s2><s3>SAU</s3><sZ>28 aut.</sZ></inist:fA14><country>Arabie saoudite</country><wicri:noRegion>King Saud Bin Abdulaziz University for Health Sciences</wicri:noRegion></affiliation></author><author><name sortKey="Sandi, Freddy" sort="Sandi, Freddy" uniqKey="Sandi F" first="Freddy" last="Sandi">Freddy Sandi</name><affiliation wicri:level="1"><inist:fA14 i1="24"><s1>Hospital Obrero No.1</s1><s2>La Paz</s2><s3>BOL</s3><sZ>29 aut.</sZ></inist:fA14><country>Bolivie</country><wicri:noRegion>Hospital Obrero No.1</wicri:noRegion></affiliation></author><author><name sortKey="Jibaja, Manuel" sort="Jibaja, Manuel" uniqKey="Jibaja M" first="Manuel" last="Jibaja">Manuel Jibaja</name><affiliation wicri:level="1"><inist:fA14 i1="25"><s1>Hospital Eugenio Espejo</s1><s2>Quito</s2><s3>ECU</s3><sZ>30 aut.</sZ></inist:fA14><country>Équateur</country><wicri:noRegion>Hospital Eugenio Espejo</wicri:noRegion></affiliation></author><author><name sortKey="Amin, Pravin" sort="Amin, Pravin" uniqKey="Amin P" first="Pravin" last="Amin">Pravin Amin</name></author><author><name sortKey="Younsuck Koh" sort="Younsuck Koh" uniqKey="Younsuck Koh" last="Younsuck Koh">YOUNSUCK KOH</name></author><author><name sortKey="Kuiper, Michael A" sort="Kuiper, Michael A" uniqKey="Kuiper M" first="Michael A." last="Kuiper">Michael A. Kuiper</name></author><author><name sortKey="Bulow, Hans Henrik" sort="Bulow, Hans Henrik" uniqKey="Bulow H" first="Hans-Henrik" last="Bülow">Hans-Henrik Bülow</name></author><author><name sortKey="Zeggwagh, Amine Ali" sort="Zeggwagh, Amine Ali" uniqKey="Zeggwagh A" first="Amine Ali" last="Zeggwagh">Amine Ali Zeggwagh</name></author><author><name sortKey="Anzueto, Antonio" sort="Anzueto, Antonio" uniqKey="Anzueto A" first="Antonio" last="Anzueto">Antonio Anzueto</name></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">13-0249902</idno><date when="2013">2013</date><idno type="stanalyst">PASCAL 13-0249902 INIST</idno><idno type="RBID">Pascal:13-0249902</idno><idno type="wicri:Area/PascalFrancis/Corpus">000922</idno><idno type="wicri:Area/PascalFrancis/Curation">005555</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000966</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000966</idno><idno type="wicri:doubleKey">1073-449X:2013:Esteban A:evolution:of:mortality</idno><idno type="wicri:Area/Main/Merge">005140</idno><idno type="wicri:Area/Main/Curation">004F63</idno><idno type="wicri:Area/Main/Exploration">004F63</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Evolution of Mortality over Time in Patients Receiving Mechanical Ventilation</title><author><name sortKey="Esteban, Andres" sort="Esteban, Andres" uniqKey="Esteban A" first="Andrés" last="Esteban">Andrés Esteban</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Hospital Universitario de Getafe & Centro de Investigación Biomédica en red de Enfermedades Respiratorias</s1><s3>ESP</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Hospital Universitario de Getafe & Centro de Investigación Biomédica en red de Enfermedades Respiratorias</wicri:noRegion></affiliation></author><author><name sortKey="Frutos Vivar, Fernando" sort="Frutos Vivar, Fernando" uniqKey="Frutos Vivar F" first="Fernando" last="Frutos-Vivar">Fernando Frutos-Vivar</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Hospital Universitario de Getafe & Centro de Investigación Biomédica en red de Enfermedades Respiratorias</s1><s3>ESP</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Hospital Universitario de Getafe & Centro de Investigación Biomédica en red de Enfermedades Respiratorias</wicri:noRegion></affiliation></author><author><name sortKey="Muriel, Alfonso" sort="Muriel, Alfonso" uniqKey="Muriel A" first="Alfonso" last="Muriel">Alfonso Muriel</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Clinical Biostatistics, Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria & Centro de Investigación Biomédica en red de Epidemiología y Salud Pública</s1><s3>ESP</s3><sZ>3 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Department of Clinical Biostatistics, Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria & Centro de Investigación Biomédica en red de Epidemiología y Salud Pública</wicri:noRegion></affiliation></author><author><name sortKey="Ferguson, Niall D" sort="Ferguson, Niall D" uniqKey="Ferguson N" first="Niall D." last="Ferguson">Niall D. Ferguson</name><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Interdepartmental Division of Critical Care Medicine, and Departments of Medicine and Physiology, University of Toronto</s1><s3>CAN</s3><sZ>4 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Pe Uelas, Oscar" sort="Pe Uelas, Oscar" uniqKey="Pe Uelas O" first="Oscar" last="Pe Uelas">Oscar Pe Uelas</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Hospital Universitario de Getafe & Centro de Investigación Biomédica en red de Enfermedades Respiratorias</s1><s3>ESP</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Hospital Universitario de Getafe & Centro de Investigación Biomédica en red de Enfermedades Respiratorias</wicri:noRegion></affiliation></author><author><name sortKey="Abraira, Victor" sort="Abraira, Victor" uniqKey="Abraira V" first="Victor" last="Abraira">Victor Abraira</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Clinical Biostatistics, Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria & Centro de Investigación Biomédica en red de Epidemiología y Salud Pública</s1><s3>ESP</s3><sZ>3 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Department of Clinical Biostatistics, Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria & Centro de Investigación Biomédica en red de Epidemiología y Salud Pública</wicri:noRegion></affiliation></author><author><name sortKey="Raymondos, Konstantinos" sort="Raymondos, Konstantinos" uniqKey="Raymondos K" first="Konstantinos" last="Raymondos">Konstantinos Raymondos</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Medizinische Hochschule Hannover</s1><s3>DEU</s3><sZ>7 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Medizinische Hochschule Hannover</wicri:noRegion><wicri:noRegion>Medizinische Hochschule Hannover</wicri:noRegion></affiliation></author><author><name sortKey="Rios, Fernando" sort="Rios, Fernando" uniqKey="Rios F" first="Fernando" last="Rios">Fernando Rios</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Hospital Nacional Alejandro Posadas</s1><s2>Buenos Aires</s2><s3>ARG</s3><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>Argentine</country><wicri:noRegion>Hospital Nacional Alejandro Posadas</wicri:noRegion></affiliation></author><author><name sortKey="Nin, Nicolas" sort="Nin, Nicolas" uniqKey="Nin N" first="Nicolas" last="Nin">Nicolas Nin</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Hospital Universitario de Getafe & Centro de Investigación Biomédica en red de Enfermedades Respiratorias</s1><s3>ESP</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Hospital Universitario de Getafe & Centro de Investigación Biomédica en red de Enfermedades Respiratorias</wicri:noRegion></affiliation></author><author><name sortKey="Apezteguia, Carlos" sort="Apezteguia, Carlos" uniqKey="Apezteguia C" first="Carlos" last="Apezteguia">Carlos Apezteguia</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Hospital Nacional Alejandro Posadas</s1><s2>Buenos Aires</s2><s3>ARG</s3><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>Argentine</country><wicri:noRegion>Hospital Nacional Alejandro Posadas</wicri:noRegion></affiliation></author><author><name sortKey="Violi, Damian A" sort="Violi, Damian A" uniqKey="Violi D" first="Damian A." last="Violi">Damian A. Violi</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Hospital Interzonal General de Agudos Dr. Luis Güemes</s1><s2>Haedo</s2><s3>ARG</s3><sZ>11 aut.</sZ></inist:fA14><country>Argentine</country><wicri:noRegion>Hospital Interzonal General de Agudos Dr. Luis Güemes</wicri:noRegion></affiliation></author><author><name sortKey="Thille, Arnaud W" sort="Thille, Arnaud W" uniqKey="Thille A" first="Arnaud W." last="Thille">Arnaud W. Thille</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Cenre Hospitalier Universitaire Henri Mondor</s1><s2>Creteil</s2><s3>FRA</s3><sZ>12 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Créteil</settlement></placeName></affiliation></author><author><name sortKey="Brochard, Laurent" sort="Brochard, Laurent" uniqKey="Brochard L" first="Laurent" last="Brochard">Laurent Brochard</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Geneva University Hospital</s1><s2>Geneva</s2><s3>CHE</s3><sZ>13 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Geneva University Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Gonzalez, Marco" sort="Gonzalez, Marco" uniqKey="Gonzalez M" first="Marco" last="González">Marco González</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Clínica Medellín & Universidad Pontificia Bolivariana</s1><s2>Medellín</s2><s3>COL</s3><sZ>14 aut.</sZ></inist:fA14><country>Colombie</country><wicri:noRegion>Clínica Medellín & Universidad Pontificia Bolivariana</wicri:noRegion></affiliation></author><author><name sortKey="Villagomez, Asisclo J" sort="Villagomez, Asisclo J" uniqKey="Villagomez A" first="Asisclo J." last="Villagomez">Asisclo J. Villagomez</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Hospital Regional 1° de Octubre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado</s1><s2>México DF</s2><s3>MEX</s3><sZ>15 aut.</sZ></inist:fA14><country>Mexique</country><wicri:noRegion>México DF</wicri:noRegion></affiliation></author><author><name sortKey="Hurtado, Javier" sort="Hurtado, Javier" uniqKey="Hurtado J" first="Javier" last="Hurtado">Javier Hurtado</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Hospital de Clínicas de Montevideo</s1><s3>URY</s3><sZ>16 aut.</sZ></inist:fA14><country>Uruguay</country><wicri:noRegion>Hospital de Clínicas de Montevideo</wicri:noRegion></affiliation></author><author><name sortKey="Davies, Andrew R" sort="Davies, Andrew R" uniqKey="Davies A" first="Andrew R." last="Davies">Andrew R. Davies</name><affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Alfred Hospital & Monash University</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>17 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Bin Du" sort="Bin Du" uniqKey="Bin Du" last="Bin Du">BIN DU</name><affiliation wicri:level="3"><inist:fA14 i1="13"><s1>Peking Union Medical College Hospital</s1><s2>Beijing</s2><s3>CHN</s3><sZ>18 aut.</sZ></inist:fA14><country>République populaire de Chine</country><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Maggiore, Salvatore M" sort="Maggiore, Salvatore M" uniqKey="Maggiore S" first="Salvatore M." last="Maggiore">Salvatore M. Maggiore</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Policlinico "Agostino Gemelli," Università Cattolica Del Sacro Cuore</s1><s2>Roma</s2><s3>ITA</s3><sZ>19 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Pelosi, Paolo" sort="Pelosi, Paolo" uniqKey="Pelosi P" first="Paolo" last="Pelosi">Paolo Pelosi</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Universita' degli Studi</s1><s2>Genoa</s2><s3>ITA</s3><sZ>20 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Genoa</wicri:noRegion></affiliation></author><author><name sortKey="Soto, Luis" sort="Soto, Luis" uniqKey="Soto L" first="Luis" last="Soto">Luis Soto</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>Instituto Nacional del Tórax de Santiago</s1><s3>CHL</s3><sZ>21 aut.</sZ></inist:fA14><country>Chili</country><wicri:noRegion>Instituto Nacional del Tórax de Santiago</wicri:noRegion></affiliation></author><author><name sortKey="Tomicic, Vinko" sort="Tomicic, Vinko" uniqKey="Tomicic V" first="Vinko" last="Tomicic">Vinko Tomicic</name><affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Clínica Las Lilas de Santiago</s1><s3>CHL</s3><sZ>22 aut.</sZ></inist:fA14><country>Chili</country><wicri:noRegion>Clínica Las Lilas de Santiago</wicri:noRegion></affiliation></author><author><name sortKey="D Empaire, Gabriel" sort="D Empaire, Gabriel" uniqKey="D Empaire G" first="Gabriel" last="D'Empaire">Gabriel D'Empaire</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Hospital de Clínicas de Caracas</s1><s3>VEN</s3><sZ>23 aut.</sZ></inist:fA14><country>Venezuela</country><wicri:noRegion>Hospital de Clínicas de Caracas</wicri:noRegion></affiliation></author><author><name sortKey="Matamis, Dimitrios" sort="Matamis, Dimitrios" uniqKey="Matamis D" first="Dimitrios" last="Matamis">Dimitrios Matamis</name><affiliation wicri:level="1"><inist:fA14 i1="19"><s1>Papageorgiou Hospital</s1><s2>Thessaloniki</s2><s3>GRC</s3><sZ>24 aut.</sZ></inist:fA14><country>Grèce</country><wicri:noRegion>Papageorgiou Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Abroug, Fekri" sort="Abroug, Fekri" uniqKey="Abroug F" first="Fekri" last="Abroug">Fekri Abroug</name><affiliation wicri:level="1"><inist:fA14 i1="20"><s1>Hospital Fattouma Bourguina</s1><s2>Monastir</s2><s3>TUN</s3><sZ>25 aut.</sZ></inist:fA14><country>Tunisie</country><wicri:noRegion>Hospital Fattouma Bourguina</wicri:noRegion></affiliation></author><author><name sortKey="Moreno, Rui P" sort="Moreno, Rui P" uniqKey="Moreno R" first="Rui P." last="Moreno">Rui P. Moreno</name><affiliation wicri:level="1"><inist:fA14 i1="21"><s1>Unidade de Cuidados Intensivos Neurocriticos, Hospital de São José, Centro Hospitalar de Lisboa Central</s1><s2>Lisbon</s2><s3>PRT</s3><sZ>26 aut.</sZ></inist:fA14><country>Portugal</country><wicri:noRegion>Lisbon</wicri:noRegion></affiliation></author><author><name sortKey="Soares, Marco Antonio" sort="Soares, Marco Antonio" uniqKey="Soares M" first="Marco Antonio" last="Soares">Marco Antonio Soares</name><affiliation wicri:level="3"><inist:fA14 i1="22"><s1>Hospital Universitário São José</s1><s2>Belo Horizonte</s2><s3>BRA</s3><sZ>27 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">Belo Horizonte</settlement><region type="state">Minas Gerais</region></placeName></affiliation></author><author><name sortKey="Arabi, Yaseen" sort="Arabi, Yaseen" uniqKey="Arabi Y" first="Yaseen" last="Arabi">Yaseen Arabi</name><affiliation wicri:level="1"><inist:fA14 i1="23"><s1>King Saud Bin Abdulaziz University for Health Sciences</s1><s2>Riyadh</s2><s3>SAU</s3><sZ>28 aut.</sZ></inist:fA14><country>Arabie saoudite</country><wicri:noRegion>King Saud Bin Abdulaziz University for Health Sciences</wicri:noRegion></affiliation></author><author><name sortKey="Sandi, Freddy" sort="Sandi, Freddy" uniqKey="Sandi F" first="Freddy" last="Sandi">Freddy Sandi</name><affiliation wicri:level="1"><inist:fA14 i1="24"><s1>Hospital Obrero No.1</s1><s2>La Paz</s2><s3>BOL</s3><sZ>29 aut.</sZ></inist:fA14><country>Bolivie</country><wicri:noRegion>Hospital Obrero No.1</wicri:noRegion></affiliation></author><author><name sortKey="Jibaja, Manuel" sort="Jibaja, Manuel" uniqKey="Jibaja M" first="Manuel" last="Jibaja">Manuel Jibaja</name><affiliation wicri:level="1"><inist:fA14 i1="25"><s1>Hospital Eugenio Espejo</s1><s2>Quito</s2><s3>ECU</s3><sZ>30 aut.</sZ></inist:fA14><country>Équateur</country><wicri:noRegion>Hospital Eugenio Espejo</wicri:noRegion></affiliation></author><author><name sortKey="Amin, Pravin" sort="Amin, Pravin" uniqKey="Amin P" first="Pravin" last="Amin">Pravin Amin</name></author><author><name sortKey="Younsuck Koh" sort="Younsuck Koh" uniqKey="Younsuck Koh" last="Younsuck Koh">YOUNSUCK KOH</name></author><author><name sortKey="Kuiper, Michael A" sort="Kuiper, Michael A" uniqKey="Kuiper M" first="Michael A." last="Kuiper">Michael A. Kuiper</name></author><author><name sortKey="Bulow, Hans Henrik" sort="Bulow, Hans Henrik" uniqKey="Bulow H" first="Hans-Henrik" last="Bülow">Hans-Henrik Bülow</name></author><author><name sortKey="Zeggwagh, Amine Ali" sort="Zeggwagh, Amine Ali" uniqKey="Zeggwagh A" first="Amine Ali" last="Zeggwagh">Amine Ali Zeggwagh</name></author><author><name sortKey="Anzueto, Antonio" sort="Anzueto, Antonio" uniqKey="Anzueto A" first="Antonio" last="Anzueto">Antonio Anzueto</name></author></analytic><series><title level="j" type="main">American journal of respiratory and critical care medicine</title><title level="j" type="abbreviated">Am. j. respir. crit. care med.</title><idno type="ISSN">1073-449X</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">American journal of respiratory and critical care medicine</title><title level="j" type="abbreviated">Am. j. respir. crit. care med.</title><idno type="ISSN">1073-449X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Artificial ventilation</term><term>Cohort study</term><term>Epidemiology</term><term>Evolution</term><term>Human</term><term>Intensive care</term><term>Mechanical ventilation</term><term>Mortality</term><term>Patient</term><term>Prognosis</term><term>Public health</term><term>Respiratory disease</term><term>Resuscitation</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Pathologie de l'appareil respiratoire</term><term>Evolution</term><term>Mortalité</term><term>Epidémiologie</term><term>Pronostic</term><term>Homme</term><term>Malade</term><term>Ventilation mécanique</term><term>Ventilation artificielle</term><term>Santé publique</term><term>Etude cohorte</term><term>Réanimation</term><term>Soin intensif</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Mortalité</term><term>Homme</term><term>Santé publique</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Rationale: Baseline characteristics and management have changed overtime in patients requiring mechanical ventilation; however, the impact of these changes on patient outcomes is unclear. Objectives: To estimate whether mortality in mechanically ventilated patients has changed overtime. Methods: Prospective cohort studies conducted in 1998, 2004, and 2010, including patients receiving mechanical ventilation for more than 12 hours in a 1-month period, from 927 units in 40 countries. To examine effects over time on mortality in intensive care units, we performed generalized estimating equation models. 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 H<sub>2</sub>O [SD = 3.8] in 1998 to 7.0 cm of H<sub>2</sub>O [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: Patient characteristics and ventilation practices have changed overtime, and outcomes of mechanically ventilated patients have improved.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Arabie saoudite</li><li>Argentine</li><li>Australie</li><li>Bolivie</li><li>Brésil</li><li>Canada</li><li>Chili</li><li>Colombie</li><li>Espagne</li><li>France</li><li>Grèce</li><li>Italie</li><li>Mexique</li><li>Portugal</li><li>République populaire de Chine</li><li>Suisse</li><li>Tunisie</li><li>Uruguay</li><li>Venezuela</li><li>Équateur</li></country><region><li>Latium</li><li>Minas Gerais</li><li>Ontario</li><li>Victoria (État)</li><li>Île-de-France</li></region><settlement><li>Belo Horizonte</li><li>Créteil</li><li>Melbourne</li><li>Pékin</li><li>Rome</li><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><noCountry><name sortKey="Amin, Pravin" sort="Amin, Pravin" uniqKey="Amin P" first="Pravin" last="Amin">Pravin Amin</name><name sortKey="Anzueto, Antonio" sort="Anzueto, Antonio" uniqKey="Anzueto A" first="Antonio" last="Anzueto">Antonio Anzueto</name><name sortKey="Bulow, Hans Henrik" sort="Bulow, Hans Henrik" uniqKey="Bulow H" first="Hans-Henrik" last="Bülow">Hans-Henrik Bülow</name><name sortKey="Kuiper, Michael A" sort="Kuiper, Michael A" uniqKey="Kuiper M" first="Michael A." last="Kuiper">Michael A. Kuiper</name><name sortKey="Younsuck Koh" sort="Younsuck Koh" uniqKey="Younsuck Koh" last="Younsuck Koh">YOUNSUCK KOH</name><name sortKey="Zeggwagh, Amine Ali" sort="Zeggwagh, Amine Ali" uniqKey="Zeggwagh A" first="Amine Ali" last="Zeggwagh">Amine Ali Zeggwagh</name></noCountry><country name="Espagne"><noRegion><name sortKey="Esteban, Andres" sort="Esteban, Andres" uniqKey="Esteban A" first="Andrés" last="Esteban">Andrés Esteban</name></noRegion><name sortKey="Abraira, Victor" sort="Abraira, Victor" uniqKey="Abraira V" first="Victor" last="Abraira">Victor Abraira</name><name sortKey="Frutos Vivar, Fernando" sort="Frutos Vivar, Fernando" uniqKey="Frutos Vivar F" first="Fernando" last="Frutos-Vivar">Fernando Frutos-Vivar</name><name sortKey="Muriel, Alfonso" sort="Muriel, Alfonso" uniqKey="Muriel A" first="Alfonso" last="Muriel">Alfonso Muriel</name><name sortKey="Nin, Nicolas" sort="Nin, Nicolas" uniqKey="Nin N" first="Nicolas" last="Nin">Nicolas Nin</name><name sortKey="Pe Uelas, Oscar" sort="Pe Uelas, Oscar" uniqKey="Pe Uelas O" first="Oscar" last="Pe Uelas">Oscar Pe Uelas</name></country><country name="Canada"><region name="Ontario"><name sortKey="Ferguson, Niall D" sort="Ferguson, Niall D" uniqKey="Ferguson N" first="Niall D." last="Ferguson">Niall D. 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Thille</name></region></country><country name="Suisse"><noRegion><name sortKey="Brochard, Laurent" sort="Brochard, Laurent" uniqKey="Brochard L" first="Laurent" last="Brochard">Laurent Brochard</name></noRegion></country><country name="Colombie"><noRegion><name sortKey="Gonzalez, Marco" sort="Gonzalez, Marco" uniqKey="Gonzalez M" first="Marco" last="González">Marco González</name></noRegion></country><country name="Mexique"><noRegion><name sortKey="Villagomez, Asisclo J" sort="Villagomez, Asisclo J" uniqKey="Villagomez A" first="Asisclo J." last="Villagomez">Asisclo J. Villagomez</name></noRegion></country><country name="Uruguay"><noRegion><name sortKey="Hurtado, Javier" sort="Hurtado, Javier" uniqKey="Hurtado J" first="Javier" last="Hurtado">Javier Hurtado</name></noRegion></country><country name="Australie"><region name="Victoria (État)"><name sortKey="Davies, Andrew R" sort="Davies, Andrew R" uniqKey="Davies A" first="Andrew R." last="Davies">Andrew R. Davies</name></region></country><country name="République populaire de Chine"><noRegion><name sortKey="Bin Du" sort="Bin Du" uniqKey="Bin Du" last="Bin Du">BIN DU</name></noRegion></country><country name="Italie"><region name="Latium"><name sortKey="Maggiore, Salvatore M" sort="Maggiore, Salvatore M" uniqKey="Maggiore S" first="Salvatore M." last="Maggiore">Salvatore M. Maggiore</name></region><name sortKey="Pelosi, Paolo" sort="Pelosi, Paolo" uniqKey="Pelosi P" first="Paolo" last="Pelosi">Paolo Pelosi</name></country><country name="Chili"><noRegion><name sortKey="Soto, Luis" sort="Soto, Luis" uniqKey="Soto L" first="Luis" last="Soto">Luis Soto</name></noRegion><name sortKey="Tomicic, Vinko" sort="Tomicic, Vinko" uniqKey="Tomicic V" first="Vinko" last="Tomicic">Vinko Tomicic</name></country><country name="Venezuela"><noRegion><name sortKey="D Empaire, Gabriel" sort="D Empaire, Gabriel" uniqKey="D Empaire G" first="Gabriel" last="D'Empaire">Gabriel D'Empaire</name></noRegion></country><country name="Grèce"><noRegion><name sortKey="Matamis, Dimitrios" sort="Matamis, Dimitrios" uniqKey="Matamis D" first="Dimitrios" last="Matamis">Dimitrios Matamis</name></noRegion></country><country name="Tunisie"><noRegion><name sortKey="Abroug, Fekri" sort="Abroug, Fekri" uniqKey="Abroug F" first="Fekri" last="Abroug">Fekri Abroug</name></noRegion></country><country name="Portugal"><noRegion><name sortKey="Moreno, Rui P" sort="Moreno, Rui P" uniqKey="Moreno R" first="Rui P." last="Moreno">Rui P. Moreno</name></noRegion></country><country name="Brésil"><region name="Minas Gerais"><name sortKey="Soares, Marco Antonio" sort="Soares, Marco Antonio" uniqKey="Soares M" first="Marco Antonio" last="Soares">Marco Antonio Soares</name></region></country><country name="Arabie saoudite"><noRegion><name sortKey="Arabi, Yaseen" sort="Arabi, Yaseen" uniqKey="Arabi Y" first="Yaseen" last="Arabi">Yaseen Arabi</name></noRegion></country><country name="Bolivie"><noRegion><name sortKey="Sandi, Freddy" sort="Sandi, Freddy" uniqKey="Sandi F" first="Freddy" last="Sandi">Freddy Sandi</name></noRegion></country><country name="Équateur"><noRegion><name sortKey="Jibaja, Manuel" sort="Jibaja, Manuel" uniqKey="Jibaja M" first="Manuel" last="Jibaja">Manuel Jibaja</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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