Epidemiological Characteristics, Ventilator Management, and Clinical Outcome in Patients Receiving Invasive Ventilation in Intensive Care Units from 10 Asian Middle-Income Countries (PRoVENT-iMiC) : An International, Multicenter, Prospective Study
Epidemiology, ventilator management, and outcome in patients receiving invasive ventilation in intensive care units (ICUs) in middle-income countries are largely unknown. PRactice of VENTilation in Middle-income Countries is an international multicenter 4-week observational study of invasively ventilated adult patients in 54 ICUs from 10 Asian countries conducted in 2017/18. Study outcomes included major ventilator settings (including tidal volume [V T ] and positive end-expiratory pressure [PEEP]); the proportion of patients at risk for acute respiratory distress syndrome (ARDS), according to the lung injury prediction score (LIPS), or with ARDS; the incidence of pulmonary complications; and ICU mortality. In 1,315 patients included, median V T was similar in patients with LIPS < 4 and patients with LIPS ≥ 4, but lower in patients with ARDS (7.90 [6.8-8.9], 8.0 [6.8-9.2], and 7.0 [5.8-8.4] mL/kg Predicted body weight; P = 0.0001). Median PEEP was similar in patients with LIPS < 4 and LIPS ≥ 4, but higher in patients with ARDS (five [5-7], five [5-8], and 10 [5-12] cmH2O; P < 0.0001). The proportions of patients with LIPS ≥ 4 or with ARDS were 68% (95% CI: 66-71) and 7% (95% CI: 6-8), respectively. Pulmonary complications increased stepwise from patients with LIPS < 4 to patients with LIPS ≥ 4 and patients with ARDS (19%, 21%, and 38% respectively; P = 0.0002), with a similar trend in ICU mortality (17%, 34%, and 45% respectively; P < 0.0001). The capacity of the LIPS to predict development of ARDS was poor (receiver operating characteristic [ROC] area under the curve [AUC] of 0.62, 95% CI: 0.54-0.70). In Asian middle-income countries, where two-thirds of ventilated patients are at risk for ARDS according to the LIPS and pulmonary complications are frequent, setting of V T is globally in line with current recommendations.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:104 |
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| Enthalten in: |
The American journal of tropical medicine and hygiene - 104(2021), 3 vom: 11. Jan., Seite 1022-1033 |
| Sprache: |
Englisch |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 14.02.2022 Date Revised 16.07.2022 published: Electronic Citation Status MEDLINE |
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| doi: |
10.4269/ajtmh.20-1177 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM319963187 |
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| 245 | 1 | 0 | |a Epidemiological Characteristics, Ventilator Management, and Clinical Outcome in Patients Receiving Invasive Ventilation in Intensive Care Units from 10 Asian Middle-Income Countries (PRoVENT-iMiC) |b An International, Multicenter, Prospective Study |
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| 500 | |a Date Revised 16.07.2022 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Epidemiology, ventilator management, and outcome in patients receiving invasive ventilation in intensive care units (ICUs) in middle-income countries are largely unknown. PRactice of VENTilation in Middle-income Countries is an international multicenter 4-week observational study of invasively ventilated adult patients in 54 ICUs from 10 Asian countries conducted in 2017/18. Study outcomes included major ventilator settings (including tidal volume [V T ] and positive end-expiratory pressure [PEEP]); the proportion of patients at risk for acute respiratory distress syndrome (ARDS), according to the lung injury prediction score (LIPS), or with ARDS; the incidence of pulmonary complications; and ICU mortality. In 1,315 patients included, median V T was similar in patients with LIPS < 4 and patients with LIPS ≥ 4, but lower in patients with ARDS (7.90 [6.8-8.9], 8.0 [6.8-9.2], and 7.0 [5.8-8.4] mL/kg Predicted body weight; P = 0.0001). Median PEEP was similar in patients with LIPS < 4 and LIPS ≥ 4, but higher in patients with ARDS (five [5-7], five [5-8], and 10 [5-12] cmH2O; P < 0.0001). The proportions of patients with LIPS ≥ 4 or with ARDS were 68% (95% CI: 66-71) and 7% (95% CI: 6-8), respectively. Pulmonary complications increased stepwise from patients with LIPS < 4 to patients with LIPS ≥ 4 and patients with ARDS (19%, 21%, and 38% respectively; P = 0.0002), with a similar trend in ICU mortality (17%, 34%, and 45% respectively; P < 0.0001). The capacity of the LIPS to predict development of ARDS was poor (receiver operating characteristic [ROC] area under the curve [AUC] of 0.62, 95% CI: 0.54-0.70). In Asian middle-income countries, where two-thirds of ventilated patients are at risk for ARDS according to the LIPS and pulmonary complications are frequent, setting of V T is globally in line with current recommendations | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 700 | 1 | |a Algera, Anna Geke |e verfasserin |4 aut | |
| 700 | 1 | |a Serpa Neto, Ary |e verfasserin |4 aut | |
| 700 | 1 | |a Ahsan, Areef |e verfasserin |4 aut | |
| 700 | 1 | |a Beane, Abigail |e verfasserin |4 aut | |
| 700 | 1 | |a Chittawatanarat, Kaweesak |e verfasserin |4 aut | |
| 700 | 1 | |a Faiz, Abul |e verfasserin |4 aut | |
| 700 | 1 | |a Haniffa, Rashan |e verfasserin |4 aut | |
| 700 | 1 | |a Hashemian, Seyed MohammadReza |e verfasserin |4 aut | |
| 700 | 1 | |a Hashmi, Madiha |e verfasserin |4 aut | |
| 700 | 1 | |a Imad, Hisham Ahmed |e verfasserin |4 aut | |
| 700 | 1 | |a Indraratna, Kanishka |e verfasserin |4 aut | |
| 700 | 1 | |a Iyer, Shivakumar |e verfasserin |4 aut | |
| 700 | 1 | |a Kayastha, Gyan |e verfasserin |4 aut | |
| 700 | 1 | |a Krishna, Bhuvana |e verfasserin |4 aut | |
| 700 | 1 | |a Ling, Tai Li |e verfasserin |4 aut | |
| 700 | 1 | |a Moosa, Hassan |e verfasserin |4 aut | |
| 700 | 1 | |a Nadjm, Behzad |e verfasserin |4 aut | |
| 700 | 1 | |a Pattnaik, Rajyabardhan |e verfasserin |4 aut | |
| 700 | 1 | |a Sampath, Sriram |e verfasserin |4 aut | |
| 700 | 1 | |a Thwaites, Louise |e verfasserin |4 aut | |
| 700 | 1 | |a Tun, Ni Ni |e verfasserin |4 aut | |
| 700 | 1 | |a Mohd Yunos, Nor'azim |e verfasserin |4 aut | |
| 700 | 1 | |a Grasso, Salvatore |e verfasserin |4 aut | |
| 700 | 1 | |a Paulus, Frederique |e verfasserin |4 aut | |
| 700 | 1 | |a Gama de Abreu, Marcelo |e verfasserin |4 aut | |
| 700 | 1 | |a Pelosi, Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a Day, Nick |e verfasserin |4 aut | |
| 700 | 1 | |a White, Nicholas J |e verfasserin |4 aut | |
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