Association between ventilatory settings and development of acute respiratory distress syndrome in mechanically ventilated patients due to brain injury.
J Crit Care
; 38: 341-345, 2017 04.
Article
em En
| MEDLINE
| ID: mdl-27914908
ABSTRACT
PURPOSE:
In neurologically critically ill patients with mechanical ventilation (MV), the development of acute respiratory distress syndrome (ARDS) is a major contributor to morbidity and mortality, but the role of ventilatory management has been scarcely evaluated. We evaluate the association of tidal volume, level of PEEP and driving pressure with the development of ARDS in a population of patients with brain injury. MATERIALS ANDMETHODS:
We performed a secondary analysis of a prospective, observational study on mechanical ventilation.RESULTS:
We included 986 patients mechanically ventilated due to an acute brain injury (hemorrhagic stroke, ischemic stroke or brain trauma). Incidence of ARDS in this cohort was 3%. Multivariate analysis suggested that driving pressure could be associated with the development of ARDS (odds ratio for unit increment of driving pressure 1.12; confidence interval for 95% 1.01 to 1.23) whereas we did not observe association for tidal volume (in ml per kg of predicted body weight) or level of PEEP. ARDS was associated with an increase in mortality, longer duration of mechanical ventilation, and longer ICU length of stay.CONCLUSIONS:
In a cohort of brain-injured patients the development of ARDS was not common. Driving pressure was associated with the development of this disease.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Respiração Artificial
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Síndrome do Desconforto Respiratório
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Lesões Encefálicas
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Volume de Ventilação Pulmonar
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Respiração com Pressão Positiva
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article