One-Year Outcomes in Patients With Acute Respiratory Distress Syndrome Enrolled in a Randomized Clinical Trial of Helmet Versus Facemask Noninvasive Ventilation
OBJECTIVES: Many survivors of acute respiratory distress syndrome have poor long-term outcomes possibly due to supportive care practices during "invasive" mechanical ventilation. Helmet noninvasive ventilation in acute respiratory distress syndrome may reduce intubation rates; however, it is unknown if avoiding intubation with helmet noninvasive ventilation alters the consequences of surviving acute respiratory distress syndrome.
DESIGN: Long-term follow-up data from a previously published randomized controlled trial.
PATIENTS: Adults patients with acute respiratory distress syndrome enrolled in a previously published clinical trial.
SETTING: Adult ICU.
INTERVENTION: None.
MEASUREMENTS AND MAIN RESULTS: The primary outcome was functional independence at 1 year after hospital discharge defined as independence in activities of daily living and ambulation. At 1 year, patients were surveyed to assess for functional independence, survival, and number of institution-free days, defined as days alive spent living at home. The presence of ICU-acquired weakness and functional independence was also assessed by a blinded therapist on hospital discharge. On hospital discharge, there was a greater prevalence of ICU-acquired weakness (79.5% vs 38.6%; p = 0.0002) and less functional independence (15.4% vs 50%; p = 0.001) in the facemask group. One-year follow-up data were collected for 81 of 83 patients (97.6%). One-year mortality was higher in the facemask group (69.2% vs 43.2%; p = 0.017). At 1 year, patients in the helmet group were more likely to be functionally independent (40.9% vs 15.4%; p = 0.015) and had more institution-free days (median, 268.5 [0-354] vs 0 [0-323]; p = 0.017).
CONCLUSIONS: Poor functional recovery after invasive mechanical ventilation for acute respiratory distress syndrome is common. Helmet noninvasive ventilation may be the first intervention that mitigates the long-term complications that plague survivors of acute respiratory distress syndrome managed with noninvasive ventilation.
| Errataetall: |
CommentIn: Crit Care Med. 2019 Feb;47(2):e164. - PMID 30653084 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:46 |
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| Enthalten in: |
Critical care medicine - 46(2018), 7 vom: 22. Juli, Seite 1078-1084 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Patel, Bhakti K [VerfasserIn] |
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| Links: |
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| Themen: |
Comparative Study |
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| Anmerkungen: |
Date Completed 27.09.2019 Date Revised 09.12.2020 published: Print CommentIn: Crit Care Med. 2019 Feb;47(2):e164. - PMID 30653084 Citation Status MEDLINE |
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| doi: |
10.1097/CCM.0000000000003124 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 100 | 1 | |a Patel, Bhakti K |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a One-Year Outcomes in Patients With Acute Respiratory Distress Syndrome Enrolled in a Randomized Clinical Trial of Helmet Versus Facemask Noninvasive Ventilation |
| 264 | 1 | |c 2018 | |
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| 500 | |a Date Completed 27.09.2019 | ||
| 500 | |a Date Revised 09.12.2020 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Crit Care Med. 2019 Feb;47(2):e164. - PMID 30653084 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVES: Many survivors of acute respiratory distress syndrome have poor long-term outcomes possibly due to supportive care practices during "invasive" mechanical ventilation. Helmet noninvasive ventilation in acute respiratory distress syndrome may reduce intubation rates; however, it is unknown if avoiding intubation with helmet noninvasive ventilation alters the consequences of surviving acute respiratory distress syndrome | ||
| 520 | |a DESIGN: Long-term follow-up data from a previously published randomized controlled trial | ||
| 520 | |a PATIENTS: Adults patients with acute respiratory distress syndrome enrolled in a previously published clinical trial | ||
| 520 | |a SETTING: Adult ICU | ||
| 520 | |a INTERVENTION: None | ||
| 520 | |a MEASUREMENTS AND MAIN RESULTS: The primary outcome was functional independence at 1 year after hospital discharge defined as independence in activities of daily living and ambulation. At 1 year, patients were surveyed to assess for functional independence, survival, and number of institution-free days, defined as days alive spent living at home. The presence of ICU-acquired weakness and functional independence was also assessed by a blinded therapist on hospital discharge. On hospital discharge, there was a greater prevalence of ICU-acquired weakness (79.5% vs 38.6%; p = 0.0002) and less functional independence (15.4% vs 50%; p = 0.001) in the facemask group. One-year follow-up data were collected for 81 of 83 patients (97.6%). One-year mortality was higher in the facemask group (69.2% vs 43.2%; p = 0.017). At 1 year, patients in the helmet group were more likely to be functionally independent (40.9% vs 15.4%; p = 0.015) and had more institution-free days (median, 268.5 [0-354] vs 0 [0-323]; p = 0.017) | ||
| 520 | |a CONCLUSIONS: Poor functional recovery after invasive mechanical ventilation for acute respiratory distress syndrome is common. Helmet noninvasive ventilation may be the first intervention that mitigates the long-term complications that plague survivors of acute respiratory distress syndrome managed with noninvasive ventilation | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 700 | 1 | |a Wolfe, Krysta S |e verfasserin |4 aut | |
| 700 | 1 | |a MacKenzie, Erica L |e verfasserin |4 aut | |
| 700 | 1 | |a Salem, Dhafer |e verfasserin |4 aut | |
| 700 | 1 | |a Esbrook, Cheryl L |e verfasserin |4 aut | |
| 700 | 1 | |a Pawlik, Amy J |e verfasserin |4 aut | |
| 700 | 1 | |a Stulberg, Megan |e verfasserin |4 aut | |
| 700 | 1 | |a Kemple, Crystal |e verfasserin |4 aut | |
| 700 | 1 | |a Teele, Megan |e verfasserin |4 aut | |
| 700 | 1 | |a Zeleny, Erin |e verfasserin |4 aut | |
| 700 | 1 | |a Macleod, Julia |e verfasserin |4 aut | |
| 700 | 1 | |a Pohlman, Anne S |e verfasserin |4 aut | |
| 700 | 1 | |a Hall, Jesse B |e verfasserin |4 aut | |
| 700 | 1 | |a Kress, John P |e verfasserin |4 aut | |
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