0000000001254822
AUTHOR
John Laffey
showing 23 related works from this author
Individualized versus fixed positive end-expiratory pressure for intraoperative mechanical ventilation in obese patients: a secondary analysis
2021
Background General anesthesia may cause atelectasis and deterioration in oxygenation in obese patients. The authors hypothesized that individualized positive end-expiratory pressure (PEEP) improves intraoperative oxygenation and ventilation distribution compared to fixed PEEP. Methods This secondary analysis included all obese patients recruited at University Hospital of Leipzig from the multicenter Protective Intraoperative Ventilation with Higher versus Lower Levels of Positive End-Expiratory Pressure in Obese Patients (PROBESE) trial (n = 42) and likewise all obese patients from a local single-center trial (n = 54). Inclusion criteria for both trials were elective laparoscopic abdominal…
Intraoperative positive end-expiratory pressure and postoperative pulmonary complications: a patient-level meta-analysis of three randomised clinical…
2022
BACKGROUND: High intraoperative PEEP with recruitment manoeuvres may improve perioperative outcomes. We re-examined this question by conducting a patient-level meta-analysis of three clinical trials in adult patients at increased risk for postoperative pulmonary complications who underwent non-cardiothoracic and non-neurological surgery. METHODS: The three trials enrolled patients at 128 hospitals in 24 countries from February 2011 to February 2018. All patients received volume-controlled ventilation with low tidal volume. Analyses were performed using one-stage, two-level, mixed modelling (site as a random effect; trial as a fixed effect). The primary outcome was a composite of postoperati…
Mechanical ventilation in patients with cardiogenic pulmonary edema: a sub-analysis of the LUNG SAFE study
2022
Supported by Centro de Investigación Biomédica en Red (CIBER)‑Enfermedades respiratorias, Madrid, Spain (CB17/06/00021) and Fundación para el Fomento en Asturias de la Investigación Científica aplicada y la tecnología (FICYT, AYUD2021/52014). RRG is the recipient of a grant from Instituto de Salud Carlos III, Madrid, Spain (CM20/00083).
Outcome of acute hypoxaemic respiratory failure: insights from the LUNG SAFE Study
2020
BackgroundCurrent incidence and outcome of patients with acute hypoxaemic respiratory failure requiring mechanical ventilation in the intensive care unit (ICU) are unknown, especially for patients not meeting criteria for acute respiratory distress syndrome (ARDS).MethodsAn international, multicentre, prospective cohort study of patients presenting with hypoxaemia early in the course of mechanical ventilation, conducted during four consecutive weeks in the winter of 2014 in 459 ICUs from 50 countries (LUNG SAFE). Patients were enrolled with arterial oxygen tension/inspiratory oxygen fraction ratio ≤300 mmHg, new pulmonary infiltrates and need for mechanical ventilation with a positive end-e…
Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome: Insights from the LUNG SAFE study
2020
Abstract Background Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence o…
Additional file 12: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S8. Patientsâ characteristics and clinical endpoints of immunocompromised (study) patients, according to the cause of immunosuppression (known, unknown). (PDF 79Â kb)
Additional file 1: of Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 count…
2018
Table S1. Additional baseline characteristics in patients with tracheostomy and no tracheostomy (n = 2377). BMI, body mass index; ICU, intensive care unit; ER, emergency room; COPD, chronic obstructive pulmonary disease; NYHA, New York heart association; AHRF, Acute hypoxemic respiratory failure; ARDS, acute respiratory distress syndrome; TRALI, transfusion-related acute lung injury; A/C, assist control; PC, pressure control; BIPAP, bilevel positive airway pressure APRV, airway pressure release ventilation; SIMV, synchronized intermittent mandatory ventilation, PRVC, pressure-regulated volume control; PSV, pressure support ventilation; HFO, high-frequency oscillation; CPAP, continuous posit…
Additional file 11: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S7. Patient characteristics and clinical endpoints of immunocompetent patients, according to the type of ventilatory support. (PDF 88Â kb)
Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute resp…
2022
Contains fulltext : 252214.pdf (Publisher’s version ) (Open Access) BACKGROUND: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. METHODS: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to defi…
Additional file 8: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Figure S2. This figure shows a Kaplan-Meier curve for hospital survival of immunocompromised patients according to the ventilation subgroup. This figure shows a Kaplan-Meier curve for hospital survival of immunocompromised patients according to the ventilation subgroup. Mortality is defined as mortality at hospital discharge or at 90Â days after onset of acute hypoxemic respiratory failure, whichever event occurred first. We assumed that patients discharged alive from the hospital before 90Â days were alive on day 90. Type of ventilator support: IMV Patients invasively ventilated from day 1, independently of the type of support received after the eventual extubation; NIV Patients treated ex…
Additional file 4: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S3. Ventilator settings during the first day of ARDS in the immunocompetent (Control) and immunocompromised (Study) groups. This table shows ventilator settings during the first day of ARDS in the immunocompetent (Control) and immunocompromised (Study) groups. (PDF 50Â kb)
Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a …
2022
Invasive mechanical ventilation; COVID-19; Critical care Ventilación mecánica invasiva; COVID-19; Cuidado crítico Ventilació mecànica invasiva; COVID-19; Atenció crítica Background Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods This is a multin…
Additional file 2: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S1. Patient characteristics of immunocompromised patients according to the type of ventilator support. This table shows patient characteristics, including comorbidities, ARDS risk factors, and illness severity at ARDS onset of immunocompromised patients according to the type of ventilator support. (PDF 74Â kb)
Immunocompromised patients with acute respiratory distress syndrome: Secondary analysis of the LUNG SAFE database
2018
Background: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiog…
Validation and utility of ARDS subphenotypes identified by machine-learning models using clinical data: an observational, multicohort, retrospective …
2022
Item does not contain fulltext BACKGROUND: Two acute respiratory distress syndrome (ARDS) subphenotypes (hyperinflammatory and hypoinflammatory) with distinct clinical and biological features and differential treatment responses have been identified using latent class analysis (LCA) in seven individual cohorts. To facilitate bedside identification of subphenotypes, clinical classifier models using readily available clinical variables have been described in four randomised controlled trials. We aimed to assess the performance of these models in observational cohorts of ARDS. METHODS: In this observational, multicohort, retrospective study, we validated two machine-learning clinical classifie…
Additional file 6: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S6. Ventilator settings during the first day of ARDS in immunocompetent (Control) and immunocompromised (Study) patients, stratified by the type of ventilatory support (IMV, NIV, NIV failure). (PDF 60Â kb)
Additional file 1: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
List of LUNG SAFE investigators. Names and affiliations of the LUNG SAFE investigators. (PDF 172Â kb)
Additional file 7: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Figure S1. Kaplan-Meier curve for hospital survival in immunocompromised patients according to ARDS severity. Kaplan-Meier curve for hospital survival in immunocompromised patients according to ARDS severity. Mortality is defined as mortality at hospital discharge or at 90Â days after onset of acute hypoxemic respiratory failure, whichever event occurred first. We assumed that patients discharged alive from the hospital before 90Â days were alive on day 90. Severity of ARDS was evaluated at the day of onset according to the Berlin definition. Note: The number of patients reported in the bottom of figure is referred to as the end of the corresponding day. (PDF 402Â kb)
Additional file 3: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S2. Factors associated with the use of noninvasive ventilation. Multivariate logistic regression model describing the factors associated with the use of noninvasive ventilation. (PDF 49Â kb)
Additional file 10: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S9. The most important factors leading to death in the ICU in immunocompetent and immunocompromised patients. (PDF 44Â kb)
Additional file 5: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S4. Adjunctive measures/therapies during at least one day during follow-up in immunocompetent and immunocompromised patients. This table shows the proportions of adjunctive measures/therapies during at least one day during follow-up in immunocompetent and immunocompromised patients. (PDF 97Â kb)
Additional file 9: of Immunocompromised patients with acute respiratory distress syndrome: secondary analysis of the LUNG SAFE database
2018
Table S5. Factors associated with hospital mortality in immunocompromised patients. Multivariate logistic regression model describing the factors associated with hospital mortality in immunocompromised patients. (PDF 49Â kb)
Additional file 2: of Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 count…
2018
Table S2 compares outcomes between early (within 7 days of ICU admission) and late (8 days and later) thoracotomy (n = 280). SD, standard deviation; ICU, intensive care unit; Q1–Q3; 25%–75% interquartile. Missing data: days of mechanical ventilation = 37; days of mechanical ventilation in patient alive at hospital discharge (90 days) = 139; length of ICU stay in patient alive at ICU discharge (90 days) = 58; length of hospital stay = 19; length of hospital stay in patient alive at ICU discharge (90 days) = 87; ICU, 28-day, 60-day, and 90-day mortality = 1. Participants were adult patients (≥ 18 years) with severe or moderate ARDS who received mechanical ventilation and had tracheostomy. Par…