Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome
Identifieur interne : 001F75 ( Pmc/Corpus ); précédent : 001F74; suivant : 001F76Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome
Auteurs : Nicolas Nin ; Alfonso Muriel ; Oscar Pe Uelas ; Laurent Brochard ; José Angel Lorente ; Niall D. Ferguson ; Konstantinos Raymondos ; Fernando Ríos ; Damian A. Violi ; Arnaud W. Thille ; Marco González ; Asisclo J. Villagomez ; Javier Hurtado ; Andrew R. Davies ; Bin Du ; Salvatore M. Maggiore ; Luis Soto ; Gabriel D Mpaire ; Dimitrios Matamis ; Fekri Abroug ; Rui P. Moreno ; Marco Antonio Soares ; Yaseen Arabi ; Freddy Sandi ; Manuel Jibaja ; Pravin Amin ; Younsuck Koh ; Michael A. Kuiper ; Hans-Henrik Bülow ; Amine Ali Zeggwagh ; Antonio Anzueto ; Jacob I. Sznajder ; Andres EstebanSource :
- Intensive care medicine [ 0342-4642 ] ; 2017.
Abstract
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).
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.
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;
Severe hypercapnia appears to be independently associated with higher ICU mortality in patients with ARDS.
Url:
DOI: 10.1007/s00134-016-4611-1
PubMed: 28108768
PubMed Central: 5630225
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome</title><author><name sortKey="Nin, Nicolas" sort="Nin, Nicolas" uniqKey="Nin N" first="Nicolas" last="Nin">Nicolas Nin</name><affiliation><nlm:aff id="A1">Hospital de Torrejón, Madrid, Spain.</nlm:aff></affiliation><affiliation><nlm:aff id="A13">Hospital Español, Montevideo, Uruguay.</nlm:aff></affiliation></author><author><name sortKey="Muriel, Alfonso" sort="Muriel, Alfonso" uniqKey="Muriel A" first="Alfonso" last="Muriel">Alfonso Muriel</name><affiliation><nlm:aff id="A2">Department of Clinical Biostatistics, Hospital Ramón Y Cajal, IRICYS and CIBERESP, Madrid, Spain.</nlm:aff></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><nlm:aff id="A3">CIBER Enfermedades Respiratorias, Madrid, Spain.</nlm:aff></affiliation><affiliation><nlm:aff id="A33">Hospital Universitario de Getafe, Carretera de Toledo, Km 12,500, 28905 Madrid, Spain.</nlm:aff></affiliation></author><author><name sortKey="Brochard, Laurent" sort="Brochard, Laurent" uniqKey="Brochard L" first="Laurent" last="Brochard">Laurent Brochard</name><affiliation><nlm:aff id="A4">Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Canada.</nlm:aff></affiliation><affiliation><nlm:aff id="A5">Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada.</nlm:aff></affiliation></author><author><name sortKey="Lorente, Jose Angel" sort="Lorente, Jose Angel" uniqKey="Lorente J" first="José Angel" last="Lorente">José Angel Lorente</name><affiliation><nlm:aff id="A3">CIBER Enfermedades Respiratorias, Madrid, Spain.</nlm:aff></affiliation><affiliation><nlm:aff id="A33">Hospital Universitario de Getafe, Carretera de Toledo, Km 12,500, 28905 Madrid, Spain.</nlm:aff></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><nlm:aff id="A6">Interdepartmental Division of Critical Care Medicine and Departments of Medicine and Physiology, University of Toronto, Toronto, Canada.</nlm:aff></affiliation></author><author><name sortKey="Raymondos, Konstantinos" sort="Raymondos, Konstantinos" uniqKey="Raymondos K" first="Konstantinos" last="Raymondos">Konstantinos Raymondos</name><affiliation><nlm:aff id="A7">Medizinische Hochschule Hannover, Hanover, Germany.</nlm:aff></affiliation></author><author><name sortKey="Rios, Fernando" sort="Rios, Fernando" uniqKey="Rios F" first="Fernando" last="Ríos">Fernando Ríos</name><affiliation><nlm:aff id="A8">Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina.</nlm:aff></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><nlm:aff id="A9">Hospital HIGA Guemes, Haedo, Argentina.</nlm:aff></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><nlm:aff id="A10">University Hospital of Poitiers, Poitiers, France.</nlm:aff></affiliation></author><author><name sortKey="Gonzalez, Marco" sort="Gonzalez, Marco" uniqKey="Gonzalez M" first="Marco" last="González">Marco González</name><affiliation><nlm:aff id="A11">Clínica Medellín and Universidad Pontificia Bolivariana, Medellín, Colombia.</nlm:aff></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><nlm:aff id="A12">Hospital Regional 1° de Octubre, ISSSTE, Mexico City, Mexico.</nlm:aff></affiliation></author><author><name sortKey="Hurtado, Javier" sort="Hurtado, Javier" uniqKey="Hurtado J" first="Javier" last="Hurtado">Javier Hurtado</name><affiliation><nlm:aff id="A13">Hospital Español, Montevideo, Uruguay.</nlm:aff></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><nlm:aff id="A14">Alfred Hospital and Monash University, Melbourne, Australia.</nlm:aff></affiliation></author><author><name sortKey="Du, Bin" sort="Du, Bin" uniqKey="Du B" first="Bin" last="Du">Bin Du</name><affiliation><nlm:aff id="A15">Peking Union Medical College Hospital, Beijing, People’s Republic of China.</nlm:aff></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><nlm:aff id="A16">Policlinico Agostino Gemelli, Università Cattolica Del Sacro Cuore, Rome, Italy.</nlm:aff></affiliation></author><author><name sortKey="Soto, Luis" sort="Soto, Luis" uniqKey="Soto L" first="Luis" last="Soto">Luis Soto</name><affiliation><nlm:aff id="A17">Instituto Nacional del Tórax de Santiago, Santiago, Chile.</nlm:aff></affiliation></author><author><name sortKey="D Mpaire, Gabriel" sort="D Mpaire, Gabriel" uniqKey="D Mpaire G" first="Gabriel" last="D Mpaire">Gabriel D Mpaire</name><affiliation><nlm:aff id="A18">Hospital de Clínicas de Caracas, Caracas, Venezuela.</nlm:aff></affiliation></author><author><name sortKey="Matamis, Dimitrios" sort="Matamis, Dimitrios" uniqKey="Matamis D" first="Dimitrios" last="Matamis">Dimitrios Matamis</name><affiliation><nlm:aff id="A19">Papageorgiou Hospital, Thessaloniki, Greece.</nlm:aff></affiliation></author><author><name sortKey="Abroug, Fekri" sort="Abroug, Fekri" uniqKey="Abroug F" first="Fekri" last="Abroug">Fekri Abroug</name><affiliation><nlm:aff id="A20">Hospital Fattouma Bourguina, Monastir, Tunisia.</nlm:aff></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><nlm:aff id="A21">UCINC, Hospital de Sao José, Centro Hospitalar de Lisboa Central, E.P.E., Lisbon, Portugal.</nlm:aff></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><nlm:aff id="A22">Hospital Universitario Sao José, Belo Horizonte, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Arabi, Yaseen" sort="Arabi, Yaseen" uniqKey="Arabi Y" first="Yaseen" last="Arabi">Yaseen Arabi</name><affiliation><nlm:aff id="A23">King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.</nlm:aff></affiliation></author><author><name sortKey="Sandi, Freddy" sort="Sandi, Freddy" uniqKey="Sandi F" first="Freddy" last="Sandi">Freddy Sandi</name><affiliation><nlm:aff id="A24">Hospital Obrero No. 1, La Paz, Bolivia.</nlm:aff></affiliation></author><author><name sortKey="Jibaja, Manuel" sort="Jibaja, Manuel" uniqKey="Jibaja M" first="Manuel" last="Jibaja">Manuel Jibaja</name><affiliation><nlm:aff id="A25">Hospital Eugenio Espejo, Quito, Ecuador.</nlm:aff></affiliation></author><author><name sortKey="Amin, Pravin" sort="Amin, Pravin" uniqKey="Amin P" first="Pravin" last="Amin">Pravin Amin</name><affiliation><nlm:aff id="A26">Bombay Hospital Institute of Medical Sciences, Mumbai, India.</nlm:aff></affiliation></author><author><name sortKey="Koh, Younsuck" sort="Koh, Younsuck" uniqKey="Koh Y" first="Younsuck" last="Koh">Younsuck Koh</name><affiliation><nlm:aff id="A27">Asan Medical Center, University of Ulsan, Seoul, Republic of Korea.</nlm:aff></affiliation></author><author><name sortKey="Kuiper, Michael A" sort="Kuiper, Michael A" uniqKey="Kuiper M" first="Michael A." last="Kuiper">Michael A. Kuiper</name><affiliation><nlm:aff id="A28">Medical Center Leeuwarden (MCL), Leeuwarden, The Netherlands.</nlm:aff></affiliation></author><author><name sortKey="Bulow, Hans Henrik" sort="Bulow, Hans Henrik" uniqKey="Bulow H" first="Hans-Henrik" last="Bülow">Hans-Henrik Bülow</name><affiliation><nlm:aff id="A29">Holbaek Hospital, University of Copenhagen, Copenhagen, Region Zealand, Denmark.</nlm:aff></affiliation></author><author><name sortKey="Zeggwagh, Amine Ali" sort="Zeggwagh, Amine Ali" uniqKey="Zeggwagh A" first="Amine Ali" last="Zeggwagh">Amine Ali Zeggwagh</name><affiliation><nlm:aff id="A30">Hospital Ibn Sina, Rabat, Morocco.</nlm:aff></affiliation></author><author><name sortKey="Anzueto, Antonio" sort="Anzueto, Antonio" uniqKey="Anzueto A" first="Antonio" last="Anzueto">Antonio Anzueto</name><affiliation><nlm:aff id="A31">South Texas Veterans Health Care System and University of Texas Health Science Center, San Antonio, TX, USA.</nlm:aff></affiliation></author><author><name sortKey="Sznajder, Jacob I" sort="Sznajder, Jacob I" uniqKey="Sznajder J" first="Jacob I." last="Sznajder">Jacob I. Sznajder</name><affiliation><nlm:aff id="A32">Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.</nlm:aff></affiliation></author><author><name sortKey="Esteban, Andres" sort="Esteban, Andres" uniqKey="Esteban A" first="Andres" last="Esteban">Andres Esteban</name><affiliation><nlm:aff id="A3">CIBER Enfermedades Respiratorias, Madrid, Spain.</nlm:aff></affiliation><affiliation><nlm:aff id="A33">Hospital Universitario de Getafe, Carretera de Toledo, Km 12,500, 28905 Madrid, Spain.</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28108768</idno><idno type="pmc">5630225</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630225</idno><idno type="RBID">PMC:5630225</idno><idno type="doi">10.1007/s00134-016-4611-1</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">001F75</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001F75</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome</title><author><name sortKey="Nin, Nicolas" sort="Nin, Nicolas" uniqKey="Nin N" first="Nicolas" last="Nin">Nicolas Nin</name><affiliation><nlm:aff id="A1">Hospital de Torrejón, Madrid, Spain.</nlm:aff></affiliation><affiliation><nlm:aff id="A13">Hospital Español, Montevideo, Uruguay.</nlm:aff></affiliation></author><author><name sortKey="Muriel, Alfonso" sort="Muriel, Alfonso" uniqKey="Muriel A" first="Alfonso" last="Muriel">Alfonso Muriel</name><affiliation><nlm:aff id="A2">Department of Clinical Biostatistics, Hospital Ramón Y Cajal, IRICYS and CIBERESP, Madrid, Spain.</nlm:aff></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><nlm:aff id="A3">CIBER Enfermedades Respiratorias, Madrid, Spain.</nlm:aff></affiliation><affiliation><nlm:aff id="A33">Hospital Universitario de Getafe, Carretera de Toledo, Km 12,500, 28905 Madrid, Spain.</nlm:aff></affiliation></author><author><name sortKey="Brochard, Laurent" sort="Brochard, Laurent" uniqKey="Brochard L" first="Laurent" last="Brochard">Laurent Brochard</name><affiliation><nlm:aff id="A4">Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Canada.</nlm:aff></affiliation><affiliation><nlm:aff id="A5">Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada.</nlm:aff></affiliation></author><author><name sortKey="Lorente, Jose Angel" sort="Lorente, Jose Angel" uniqKey="Lorente J" first="José Angel" last="Lorente">José Angel Lorente</name><affiliation><nlm:aff id="A3">CIBER Enfermedades Respiratorias, Madrid, Spain.</nlm:aff></affiliation><affiliation><nlm:aff id="A33">Hospital Universitario de Getafe, Carretera de Toledo, Km 12,500, 28905 Madrid, Spain.</nlm:aff></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><nlm:aff id="A6">Interdepartmental Division of Critical Care Medicine and Departments of Medicine and Physiology, University of Toronto, Toronto, Canada.</nlm:aff></affiliation></author><author><name sortKey="Raymondos, Konstantinos" sort="Raymondos, Konstantinos" uniqKey="Raymondos K" first="Konstantinos" last="Raymondos">Konstantinos Raymondos</name><affiliation><nlm:aff id="A7">Medizinische Hochschule Hannover, Hanover, Germany.</nlm:aff></affiliation></author><author><name sortKey="Rios, Fernando" sort="Rios, Fernando" uniqKey="Rios F" first="Fernando" last="Ríos">Fernando Ríos</name><affiliation><nlm:aff id="A8">Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina.</nlm:aff></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><nlm:aff id="A9">Hospital HIGA Guemes, Haedo, Argentina.</nlm:aff></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><nlm:aff id="A10">University Hospital of Poitiers, Poitiers, France.</nlm:aff></affiliation></author><author><name sortKey="Gonzalez, Marco" sort="Gonzalez, Marco" uniqKey="Gonzalez M" first="Marco" last="González">Marco González</name><affiliation><nlm:aff id="A11">Clínica Medellín and Universidad Pontificia Bolivariana, Medellín, Colombia.</nlm:aff></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><nlm:aff id="A12">Hospital Regional 1° de Octubre, ISSSTE, Mexico City, Mexico.</nlm:aff></affiliation></author><author><name sortKey="Hurtado, Javier" sort="Hurtado, Javier" uniqKey="Hurtado J" first="Javier" last="Hurtado">Javier Hurtado</name><affiliation><nlm:aff id="A13">Hospital Español, Montevideo, Uruguay.</nlm:aff></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><nlm:aff id="A14">Alfred Hospital and Monash University, Melbourne, Australia.</nlm:aff></affiliation></author><author><name sortKey="Du, Bin" sort="Du, Bin" uniqKey="Du B" first="Bin" last="Du">Bin Du</name><affiliation><nlm:aff id="A15">Peking Union Medical College Hospital, Beijing, People’s Republic of China.</nlm:aff></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><nlm:aff id="A16">Policlinico Agostino Gemelli, Università Cattolica Del Sacro Cuore, Rome, Italy.</nlm:aff></affiliation></author><author><name sortKey="Soto, Luis" sort="Soto, Luis" uniqKey="Soto L" first="Luis" last="Soto">Luis Soto</name><affiliation><nlm:aff id="A17">Instituto Nacional del Tórax de Santiago, Santiago, Chile.</nlm:aff></affiliation></author><author><name sortKey="D Mpaire, Gabriel" sort="D Mpaire, Gabriel" uniqKey="D Mpaire G" first="Gabriel" last="D Mpaire">Gabriel D Mpaire</name><affiliation><nlm:aff id="A18">Hospital de Clínicas de Caracas, Caracas, Venezuela.</nlm:aff></affiliation></author><author><name sortKey="Matamis, Dimitrios" sort="Matamis, Dimitrios" uniqKey="Matamis D" first="Dimitrios" last="Matamis">Dimitrios Matamis</name><affiliation><nlm:aff id="A19">Papageorgiou Hospital, Thessaloniki, Greece.</nlm:aff></affiliation></author><author><name sortKey="Abroug, Fekri" sort="Abroug, Fekri" uniqKey="Abroug F" first="Fekri" last="Abroug">Fekri Abroug</name><affiliation><nlm:aff id="A20">Hospital Fattouma Bourguina, Monastir, Tunisia.</nlm:aff></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><nlm:aff id="A21">UCINC, Hospital de Sao José, Centro Hospitalar de Lisboa Central, E.P.E., Lisbon, Portugal.</nlm:aff></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><nlm:aff id="A22">Hospital Universitario Sao José, Belo Horizonte, Brazil.</nlm:aff></affiliation></author><author><name sortKey="Arabi, Yaseen" sort="Arabi, Yaseen" uniqKey="Arabi Y" first="Yaseen" last="Arabi">Yaseen Arabi</name><affiliation><nlm:aff id="A23">King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.</nlm:aff></affiliation></author><author><name sortKey="Sandi, Freddy" sort="Sandi, Freddy" uniqKey="Sandi F" first="Freddy" last="Sandi">Freddy Sandi</name><affiliation><nlm:aff id="A24">Hospital Obrero No. 1, La Paz, Bolivia.</nlm:aff></affiliation></author><author><name sortKey="Jibaja, Manuel" sort="Jibaja, Manuel" uniqKey="Jibaja M" first="Manuel" last="Jibaja">Manuel Jibaja</name><affiliation><nlm:aff id="A25">Hospital Eugenio Espejo, Quito, Ecuador.</nlm:aff></affiliation></author><author><name sortKey="Amin, Pravin" sort="Amin, Pravin" uniqKey="Amin P" first="Pravin" last="Amin">Pravin Amin</name><affiliation><nlm:aff id="A26">Bombay Hospital Institute of Medical Sciences, Mumbai, India.</nlm:aff></affiliation></author><author><name sortKey="Koh, Younsuck" sort="Koh, Younsuck" uniqKey="Koh Y" first="Younsuck" last="Koh">Younsuck Koh</name><affiliation><nlm:aff id="A27">Asan Medical Center, University of Ulsan, Seoul, Republic of Korea.</nlm:aff></affiliation></author><author><name sortKey="Kuiper, Michael A" sort="Kuiper, Michael A" uniqKey="Kuiper M" first="Michael A." last="Kuiper">Michael A. Kuiper</name><affiliation><nlm:aff id="A28">Medical Center Leeuwarden (MCL), Leeuwarden, The Netherlands.</nlm:aff></affiliation></author><author><name sortKey="Bulow, Hans Henrik" sort="Bulow, Hans Henrik" uniqKey="Bulow H" first="Hans-Henrik" last="Bülow">Hans-Henrik Bülow</name><affiliation><nlm:aff id="A29">Holbaek Hospital, University of Copenhagen, Copenhagen, Region Zealand, Denmark.</nlm:aff></affiliation></author><author><name sortKey="Zeggwagh, Amine Ali" sort="Zeggwagh, Amine Ali" uniqKey="Zeggwagh A" first="Amine Ali" last="Zeggwagh">Amine Ali Zeggwagh</name><affiliation><nlm:aff id="A30">Hospital Ibn Sina, Rabat, Morocco.</nlm:aff></affiliation></author><author><name sortKey="Anzueto, Antonio" sort="Anzueto, Antonio" uniqKey="Anzueto A" first="Antonio" last="Anzueto">Antonio Anzueto</name><affiliation><nlm:aff id="A31">South Texas Veterans Health Care System and University of Texas Health Science Center, San Antonio, TX, USA.</nlm:aff></affiliation></author><author><name sortKey="Sznajder, Jacob I" sort="Sznajder, Jacob I" uniqKey="Sznajder J" first="Jacob I." last="Sznajder">Jacob I. Sznajder</name><affiliation><nlm:aff id="A32">Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.</nlm:aff></affiliation></author><author><name sortKey="Esteban, Andres" sort="Esteban, Andres" uniqKey="Esteban A" first="Andres" last="Esteban">Andres Esteban</name><affiliation><nlm:aff id="A3">CIBER Enfermedades Respiratorias, Madrid, Spain.</nlm:aff></affiliation><affiliation><nlm:aff id="A33">Hospital Universitario de Getafe, Carretera de Toledo, Km 12,500, 28905 Madrid, Spain.</nlm:aff></affiliation></author></analytic><series><title level="j">Intensive care medicine</title><idno type="ISSN">0342-4642</idno><idno type="eISSN">1432-1238</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Purpose</title><p id="P1">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).</p></sec><sec id="S2"><title>Patients and methods</title><p id="P2">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.</p></sec><sec id="S3"><title>Main outcomes</title><p id="P3">We included 1899 patients with ARDS in this study. The relationship between maximum PaCO<sub>2</sub> in the first 48 h and mortality suggests higher mortality at or above PaCO<sub>2</sub> of ≥50 mmHg. Patients with severe hypercapnia (PaCO<sub>2</sub> ≥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, PaO<sub>2</sub>/FiO<sub>2</sub> 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; <italic>p</italic> = 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; <italic>p</italic> = 0.032).</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Severe hypercapnia appears to be independently associated with higher ICU mortality in patients with ARDS.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">7704851</journal-id><journal-id journal-id-type="pubmed-jr-id">4413</journal-id><journal-id journal-id-type="nlm-ta">Intensive Care Med</journal-id><journal-id journal-id-type="iso-abbrev">Intensive Care Med</journal-id><journal-title-group><journal-title>Intensive care medicine</journal-title></journal-title-group><issn pub-type="ppub">0342-4642</issn><issn pub-type="epub">1432-1238</issn></journal-meta><article-meta><article-id pub-id-type="pmid">28108768</article-id><article-id pub-id-type="pmc">5630225</article-id><article-id pub-id-type="doi">10.1007/s00134-016-4611-1</article-id><article-id pub-id-type="manuscript">NIHMS907568</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Nin</surname><given-names>Nicolas</given-names></name><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A13">13</xref></contrib><contrib contrib-type="author"><name><surname>Muriel</surname><given-names>Alfonso</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Peñuelas</surname><given-names>Oscar</given-names></name><xref ref-type="aff" rid="A3">3</xref><xref ref-type="aff" rid="A33">33</xref></contrib><contrib contrib-type="author"><name><surname>Brochard</surname><given-names>Laurent</given-names></name><xref ref-type="aff" rid="A4">4</xref><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Lorente</surname><given-names>José Angel</given-names></name><xref ref-type="aff" rid="A3">3</xref><xref ref-type="aff" rid="A33">33</xref></contrib><contrib contrib-type="author"><name><surname>Ferguson</surname><given-names>Niall D.</given-names></name><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author"><name><surname>Raymondos</surname><given-names>Konstantinos</given-names></name><xref ref-type="aff" rid="A7">7</xref></contrib><contrib contrib-type="author"><name><surname>Ríos</surname><given-names>Fernando</given-names></name><xref ref-type="aff" rid="A8">8</xref></contrib><contrib contrib-type="author"><name><surname>Violi</surname><given-names>Damian A.</given-names></name><xref ref-type="aff" rid="A9">9</xref></contrib><contrib contrib-type="author"><name><surname>Thille</surname><given-names>Arnaud W.</given-names></name><xref ref-type="aff" rid="A10">10</xref></contrib><contrib contrib-type="author"><name><surname>González</surname><given-names>Marco</given-names></name><xref ref-type="aff" rid="A11">11</xref></contrib><contrib contrib-type="author"><name><surname>Villagomez</surname><given-names>Asisclo J.</given-names></name><xref ref-type="aff" rid="A12">12</xref></contrib><contrib contrib-type="author"><name><surname>Hurtado</surname><given-names>Javier</given-names></name><xref ref-type="aff" rid="A13">13</xref></contrib><contrib contrib-type="author"><name><surname>Davies</surname><given-names>Andrew R.</given-names></name><xref ref-type="aff" rid="A14">14</xref></contrib><contrib contrib-type="author"><name><surname>Du</surname><given-names>Bin</given-names></name><xref ref-type="aff" rid="A15">15</xref></contrib><contrib contrib-type="author"><name><surname>Maggiore</surname><given-names>Salvatore M.</given-names></name><xref ref-type="aff" rid="A16">16</xref></contrib><contrib contrib-type="author"><name><surname>Soto</surname><given-names>Luis</given-names></name><xref ref-type="aff" rid="A17">17</xref></contrib><contrib contrib-type="author"><name><surname>D’Empaire</surname><given-names>Gabriel</given-names></name><xref ref-type="aff" rid="A18">18</xref></contrib><contrib contrib-type="author"><name><surname>Matamis</surname><given-names>Dimitrios</given-names></name><xref ref-type="aff" rid="A19">19</xref></contrib><contrib contrib-type="author"><name><surname>Abroug</surname><given-names>Fekri</given-names></name><xref ref-type="aff" rid="A20">20</xref></contrib><contrib contrib-type="author"><name><surname>Moreno</surname><given-names>Rui P.</given-names></name><xref ref-type="aff" rid="A21">21</xref></contrib><contrib contrib-type="author"><name><surname>Soares</surname><given-names>Marco Antonio</given-names></name><xref ref-type="aff" rid="A22">22</xref></contrib><contrib contrib-type="author"><name><surname>Arabi</surname><given-names>Yaseen</given-names></name><xref ref-type="aff" rid="A23">23</xref></contrib><contrib contrib-type="author"><name><surname>Sandi</surname><given-names>Freddy</given-names></name><xref ref-type="aff" rid="A24">24</xref></contrib><contrib contrib-type="author"><name><surname>Jibaja</surname><given-names>Manuel</given-names></name><xref ref-type="aff" rid="A25">25</xref></contrib><contrib contrib-type="author"><name><surname>Amin</surname><given-names>Pravin</given-names></name><xref ref-type="aff" rid="A26">26</xref></contrib><contrib contrib-type="author"><name><surname>Koh</surname><given-names>Younsuck</given-names></name><xref ref-type="aff" rid="A27">27</xref></contrib><contrib contrib-type="author"><name><surname>Kuiper</surname><given-names>Michael A.</given-names></name><xref ref-type="aff" rid="A28">28</xref></contrib><contrib contrib-type="author"><name><surname>Bülow</surname><given-names>Hans-Henrik</given-names></name><xref ref-type="aff" rid="A29">29</xref></contrib><contrib contrib-type="author"><name><surname>Zeggwagh</surname><given-names>Amine Ali</given-names></name><xref ref-type="aff" rid="A30">30</xref></contrib><contrib contrib-type="author"><name><surname>Anzueto</surname><given-names>Antonio</given-names></name><xref ref-type="aff" rid="A31">31</xref></contrib><contrib contrib-type="author"><name><surname>Sznajder</surname><given-names>Jacob I.</given-names></name><xref ref-type="aff" rid="A32">32</xref></contrib><contrib contrib-type="author"><name><surname>Esteban</surname><given-names>Andres</given-names></name><xref ref-type="aff" rid="A3">3</xref><xref ref-type="aff" rid="A33">33</xref><xref ref-type="author-notes" rid="FN1">*</xref></contrib><contrib contrib-type="author"><collab>for the VENTILA Group</collab></contrib></contrib-group><aff id="A1"><label>1</label>Hospital de Torrejón, Madrid, Spain.</aff><aff id="A2"><label>2</label>Department of Clinical Biostatistics, Hospital Ramón Y Cajal, IRICYS and CIBERESP, Madrid, Spain.</aff><aff id="A3"><label>3</label>CIBER Enfermedades Respiratorias, Madrid, Spain.</aff><aff id="A4"><label>4</label>Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Canada.</aff><aff id="A5"><label>5</label>Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada.</aff><aff id="A6"><label>6</label>Interdepartmental Division of Critical Care Medicine and Departments of Medicine and Physiology, University of Toronto, Toronto, Canada.</aff><aff id="A7"><label>7</label>Medizinische Hochschule Hannover, Hanover, Germany.</aff><aff id="A8"><label>8</label>Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina.</aff><aff id="A9"><label>9</label>Hospital HIGA Guemes, Haedo, Argentina.</aff><aff id="A10"><label>10</label>University Hospital of Poitiers, Poitiers, France.</aff><aff id="A11"><label>11</label>Clínica Medellín and Universidad Pontificia Bolivariana, Medellín, Colombia.</aff><aff id="A12"><label>12</label>Hospital Regional 1° de Octubre, ISSSTE, Mexico City, Mexico.</aff><aff id="A13"><label>13</label>Hospital Español, Montevideo, Uruguay.</aff><aff id="A14"><label>14</label>Alfred Hospital and Monash University, Melbourne, Australia.</aff><aff id="A15"><label>15</label>Peking Union Medical College Hospital, Beijing, People’s Republic of China.</aff><aff id="A16"><label>16</label>Policlinico Agostino Gemelli, Università Cattolica Del Sacro Cuore, Rome, Italy.</aff><aff id="A17"><label>17</label>Instituto Nacional del Tórax de Santiago, Santiago, Chile.</aff><aff id="A18"><label>18</label>Hospital de Clínicas de Caracas, Caracas, Venezuela.</aff><aff id="A19"><label>19</label>Papageorgiou Hospital, Thessaloniki, Greece.</aff><aff id="A20"><label>20</label>Hospital Fattouma Bourguina, Monastir, Tunisia.</aff><aff id="A21"><label>21</label>UCINC, Hospital de Sao José, Centro Hospitalar de Lisboa Central, E.P.E., Lisbon, Portugal.</aff><aff id="A22"><label>22</label>Hospital Universitario Sao José, Belo Horizonte, Brazil.</aff><aff id="A23"><label>23</label>King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.</aff><aff id="A24"><label>24</label>Hospital Obrero No. 1, La Paz, Bolivia.</aff><aff id="A25"><label>25</label>Hospital Eugenio Espejo, Quito, Ecuador.</aff><aff id="A26"><label>26</label>Bombay Hospital Institute of Medical Sciences, Mumbai, India.</aff><aff id="A27"><label>27</label>Asan Medical Center, University of Ulsan, Seoul, Republic of Korea.</aff><aff id="A28"><label>28</label>Medical Center Leeuwarden (MCL), Leeuwarden, The Netherlands.</aff><aff id="A29"><label>29</label>Holbaek Hospital, University of Copenhagen, Copenhagen, Region Zealand, Denmark.</aff><aff id="A30"><label>30</label>Hospital Ibn Sina, Rabat, Morocco.</aff><aff id="A31"><label>31</label>South Texas Veterans Health Care System and University of Texas Health Science Center, San Antonio, TX, USA.</aff><aff id="A32"><label>32</label>Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.</aff><aff id="A33"><label>33</label>Hospital Universitario de Getafe, Carretera de Toledo, Km 12,500, 28905 Madrid, Spain.</aff><author-notes><corresp id="FN1"><label>*</label>Correspondence: <email>aesteban@ucigetafe.com</email>, <sup>33</sup> Hospital Universitario de Getafe, Carretera de Toledo, Km 12,500, 28905 Madrid, Spain</corresp></author-notes><pub-date pub-type="nihms-submitted"><day>22</day><month>9</month><year>2017</year></pub-date><pub-date pub-type="epub"><day>20</day><month>1</month><year>2017</year></pub-date><pub-date pub-type="ppub"><month>2</month><year>2017</year></pub-date><pub-date pub-type="pmc-release"><day>06</day><month>10</month><year>2017</year></pub-date><volume>43</volume><issue>2</issue><fpage>200</fpage><lpage>208</lpage><pmc-comment>elocation-id from pubmed: 10.1007/s00134-016-4611-1</pmc-comment>
<abstract><sec id="S1"><title>Purpose</title><p id="P1">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).</p></sec><sec id="S2"><title>Patients and methods</title><p id="P2">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.</p></sec><sec id="S3"><title>Main outcomes</title><p id="P3">We included 1899 patients with ARDS in this study. The relationship between maximum PaCO<sub>2</sub> in the first 48 h and mortality suggests higher mortality at or above PaCO<sub>2</sub> of ≥50 mmHg. Patients with severe hypercapnia (PaCO<sub>2</sub> ≥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, PaO<sub>2</sub>/FiO<sub>2</sub> 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; <italic>p</italic> = 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; <italic>p</italic> = 0.032).</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Severe hypercapnia appears to be independently associated with higher ICU mortality in patients with ARDS.</p></sec></abstract><kwd-group><kwd>Mechanical ventilation</kwd><kwd>Acute respiratory distress syndrome</kwd><kwd>Hypercapnia</kwd><kwd>ICU mortality</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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