6533b835fe1ef96bd12a005c
RESEARCH PRODUCT
Resolved versus confirmed ARDS after 24 h: insights from the LUNG SAFE study
F. MadottoT. PhamG. BellaniL. D. BosF. D. SimonisE. FanA. ArtigasL. BrochardM. J. SchultzJ. G. LaffeyA. PesentiA. EstebanL. GattinoniF. Van HarenA. LarssonD. F. McauleyM. RanieriG. RubenfeldB. T. ThompsonH. WriggeA. S. SlutskyF. RiosF. Van HarenT. SottiauxP. DepuydtF. S. LoraL. C. AzevedoE. FanG. BugedoH. QiuM. GonzalezJ. SileskyV. CernyJ. NielsenM. JibajaH. WriggeD. MatamisJ. L. RaneroP. AminS. M. HashemianK. ClarksonK. KurahashiA. VillagomezA. A. ZeggwaghL. M. HeunksJ. H. LaakeJ. E. PaloA. Do Vale FernandesD. SandescY. ArabiV. BumbasierevicN. NinJ. A. LorenteA. LarssonL. PiquilloudF. AbrougD. F. McauleyL. McnameeJ. HurtadoE. BajwaG. DémpaireH. SulaL. NunciA. CaniA. ZazuC. DelleraR. V. AlejandroJ. DaldinM. VinzioR. O. FernandezL. P. CardonnetL. R. BettiniM. C. BissoE. M. OsmanM. G. SettenP. LovazzanoJ. AlvarezV. VillarN. C. PozoN. GrubissichG. A. PlotnikowD. N. VasquezS. IlutovichN. TiribelliA. ChenaC. A. PellegriniM. G. SaenzE. EstenssoroM. BrizuelaH. GianinettoP. E. GomezV. I. CerratoM. G. BezziS. A. BorelloF. A. LoiaconoA. M. FernandezS. KnowlesC. ReynoldsD. M. InskipJ. J. MillerJ. KongC. WhiteheadS. BihariA. SevenA. KrstevskiH. J. RodgersR. T. MillarT. E. MckennaI. M. BaileyG. C. HanlonA. AnemanJ. M. LynchR. AzadJ. NealP. W. WoodsB. L. RobertsM. R. KolH. S. WongK. C. RissT. StaudingerX. WitteboleC. BergheP. A. BulpaA. M. DiveR. VerstraeteH. LebbinckP. DepuydtJ. VermassenP. MeerssemanH. CeunenJ. I. RosaD. O. BeraldoC. PirasA. M. RampinelliNassar A. P.Jr.S. MatalounM. MoockM. M. ThompsonC. H. GonçalvesA. C. P. AntônioA. AscoliR. S. BiondiD. C. FonteneleD. NobregaV. M. SalesS. ShindheD. M. A. B. P. H. IsmailJ. LaffeyF. BeloncleK. G. DaviesR. CironeV. ManoharanM. IsmailE. C. GoligherM. JassalE. NishikawaA. JaveedG. CurleyN. RittayamaiM. ParottoN. D. FergusonS. MehtaJ. KnollA. PronovostS. CanestriniA. R. BruhnP. H. GarciaF. A. AliagaP. A. FaríasJ. S. YumhaC. A. OrtizJ. E. SalasA. A. SaezL. D. VegaE. F. LabarcaF. T. MartinezN. G. CarreñoP. LoraH. LiuH. QiuL. LiuR. TangX. LuoY. AnH. ZhaoY. GaoZ. ZhaiZ. L. YeW. WangW. LiQ. LiR. ZhengW. YuJ. ShenX. LiT. YuW. LuY. Q. WuX. B. HuangZ. HeY. LuH. HanF. ZhangR. SunH. X. WangS. H. QinB. H. ZhuJ. ZhaoJ. LiuB. LiJ. L. LiuF. C. ZhouQ. J. LiX. Y. ZhangZ. Li-xinQ. Xin-huaL. JiangY. N. GaoX. Y. ZhaoY. Y. LiX. L. LiC. WangQ. YaoR. YuK. ChenH. ShaoB. QinQ. Q. HuangW. H. ZhuA. Y. HangM. X. HuaY. LiY. XuY. D. DiL. L. LingT. H. QinS. H. WangJ. QinY. HanS. ZhouM. P. VargasJ. I. S. JimenezM. A. G. RojasJ. E. Solis-quesadaC. M. Ramirez-alfaroJ. MácaP. SklienkaJ. GjedstedA. ChristiansenJ. NielsenB. G. VillamaguaM. LlanoP. BurtinG. BuzancaisP. BeuretN. PelletierS. MortazaA. MercatJ. ChellyS. JochmansN. TerziC. DaubinG. CarteauxN. De ProstJ. -D. ChicheF. DaviaudT. PhamM. FartoukhG. BarberetJ. BiehlerJ. DellamonicaD. DoyenJ. -M. ArnalA. BriquetS. HraiechL. PapazianD. RouxJ. MessikaE. KalaitzisL. DangersA. CombesS. -M. AuG. BéduneauD. CarpentierE. H. ZogheibH. DupontS. RicomeF. L. SantoliS. L. BessetP. MichelB. GeléeP. -E. DaninB. GoubauxP. J. CrovaN. T. PhanF. BerkelmansJ. C. BadieR. TapponnierJ. GallyS. KhebbebJ. -E. HerbrechtF. SchneiderP. -L. M. DeclercqJ. -P. RigaudJ. DuranteauA. HarroisR. ChabanneJ. MarinC. BigotS. ThibaultM. GhaziM. BoukhaznaS. O. ZeinJ. R. RichecoeurD. M. CombauxF. GrelonC. Le MoalE. P. SauvadetA. RobineV. LemialeD. ReuterM. DresA. DemouleD. Goldgran-toledanoL. BaboiC. GuérinR. LohnerJ. KraßlerS. SchäferK. D. ZacharowskiP. MeybohmA. W. ReskeP. SimonH. -B. F. HopfM. SchuetzT. BaltusM. N. PapanikolaouT. G. PapavasilopoulouG. A. ZacharasV. OurailogloyE. K. MouloudiE. V. MassaE. O. NagyE. E. StamouE. V. KiourtzievaM. A. OikonomouL. E. AvilaC. A. CortezJ. E. CitalánS. A. JogS. D. SableB. ShahM. GurjarA. K. BaroniaM. MemonR. MuthuchellappanV. J. RameshA. ShenoyR. UnnikrishnanS. B. DixitR. V. RhayakarN. RamakrishnanV. K. BhardwajH. L. MahtoS. V. SagarV. PalaniswamyD. GanesanS. M. HashemianH. JamaatiF. HeidariE. A. MeaneyA. NicholK. M. KnapmanD. O’croininE. S. DunneD. M. BreenK. P. ClarksonR. F. JaafarR. DwyerF. AmirO. O. AjetunmobiA. C. O’muircheartaighC. S. BlackN. TreanorD. V. CollinsW. AltafG. ZaniM. FusariS. SpadaroC. A. VoltaR. GrazianiB. BrunettiniS. PalmeseP. FormentiM. UmbrelloA. LombardoE. PecciM. BotteriM. SavioliA. ProttiA. MatteiL. SchiavoniA. TinnirelloM. TodeschiniA. GiarratanoA. CortegianiS. SherA. RossiM. M. AntonelliL. M. MontiniP. CasalenaS. ScafettiG. PanarelloG. OcchipintiN. PatronitiM. PozziR. R. BiscioneM. M. PoliF. RaimondiD. AlbieroG. CrapelliE. BeckV. PotaV. SchiavoneA. MolinF. TarantinoG. MontiE. FratiL. MirabellaG. CinnellaT. FossaliR. ColomboP. T. I. PattarinoF. MojoliA. BraschiE. E. BorottoA. N. CracchioloD. M. PalmaF. RaponiG. FotiE. R. VascottoA. CoppadoroL. BrazziL. FlorisG. A. IottiA. VentiO. YamaguchiS. TakagiH. N. MaeyamaE. WatanabeY. YamajiK. ShimizuK. ShiozakiS. FutamiS. RyosukeK. SaitoY. KameyamaK. UenoM. IzawaN. OkudaH. SuzukiT. HarasawaM. NasuT. TakadaF. ItoS. NunomiyaK. KoyamaT. AbeK. AndohK. KusumotoA. HirataA. TakabaH. KimuraS. MatsumotoU. HigashijimaH. HondaN. AokiH. ImaiY. OginoI. MizuguchiK. IchikadoK. NittaK. MochizukiT. HashidaH. TanakaT. NakamuraD. NiimiT. UedaY. KashiwaA. UchiyamaO. SabelnikovsP. OssY. HaddadK. Y. LiewS. A. ÑAmendys-silvaY. D. Jarquin-badiolaL. A. Sanchez-hurtadoS. S. Gomez-floresM. C. MarinA. J. VillagomezJ. S. LemusJ. M. FierroM. R. CervantesF. J. F. MejiaD. DectorD. M. DectorD. R. GonzalezC. R. EstrellaJ. R. Sanchez-medinaA. Ramirez-gutierrezF. G. GeorgeJ. S. AguirreJ. A. BuensusesoM. PoblanoT. DendaneA. A. ZeggwaghH. BalkhiM. ElkhayariN. SamkaouiH. EzzouineA. BenslamaM. AmorW. MaazouziN. CimicO. BeckM. M. BrunsJ. A. SchoutenM. RiniaM. RaaijmakersL. M. HeunksH. M. Van WezelS. J. HeinesU. StrauchM. P. BuiseU. StrauchJ. C. GoodsonT. S. BrowneL. NavarraA. HuntR. A. HutchisonM. B. BaileyL. NewbyC. McarthurM. KalkoffA. McleodJ. CasementD. J. HackingF. H. AndersenM. S. DolvaJ. H. LaakeA. Barratt-dueK. A. L. NoremarkE. SøreideB. Å. SjøbøA. B. GuttormsenH. H. L. YoshidoR. Z. AguilarF. A. M. OscanoaA. U. AlisasisJ. B. RoblesR. A. B. Pasanting-limB. C. TanP. AndruszkiewiczK. JakubowskaC. M. CoxoA. M. AlvarezB. S. OliveiraG. M. MontanhaN. C. BarrosC. S. PereiraA. M. MessiasJ. M. MonteiroA. M. AraujoN. T. CatorzeS. M. MarumM. J. BouwR. M. GomesV. A. BritoS. CastroJ. M. EstilitaF. M. BarrosI. M. SerraA. M. MartinhoD. R. TomescuA. MarcuO. H. BedreagM. PapuricaD. E. CorneciS. L. NegoitaE. GrigorievA. I. GritsanA. A. GazenkampfG. AlmekhlafiM. M. AlbarrakG. M. MustafaK. A. MaghrabiN. SalahuddinT. M. AisaA. S. A. JabbaryE. TabhanY. M. ArabiO. A. TrinidadH. M. A. DorziE. E. TabhanS. BolonO. SmithJ. ManceboH. Aguirre-bermeoJ. C. Lopez-delgadoF. EsteveG. RialpC. FortezaC. De HaroG. M. AlbaicetaS. De Cima-iglesiasL. Seoane-quirogaA. Ceniceros-barrosA. L. Ruiz-aguilarL. M. Claraco-vegaJ. A. SolerM. Del Carmen LorenteC. HermosaF. GordoM. Prieto-gonzálezJ. B. López-messaM. P. PerezC. P. PerezR. M. AllueF. Roche-campoM. Ibañez-santacruzS. TempranoM. C. PintadoR. De PabloP. R. A. GómezS. R. RuizS. I. MolesM. ªT. JuradoA. ArizmendiE. A. PiacentiniN. FrancoT. HonrubiaM. P. ChengE. P. LosadaJ. BlancoL. J. YusteC. Carbayo-gorrizF. G. Cazorla-barranqueroJ. G. AlonsoR. S. AldaÁ. AlgabaG. NavarroE. CereijoE. Diaz-rodriguezD. P. MarcosL. A. MonteroL. H. ParaR. J. SanchezM. A. B. NavalpotroR. D. AbadR. M. GonzálezD. P. ToribioA. G. CastroM. J. D. ArtigaO. PenuelasT. P. RoserM. F. OlgaE. G. CurtoR. M. SánchezV. P. ImmaG. M. ElisabetL. ClaveriasM. MagretA. M. PellicerL. L. RodriguezJ. Sánchez-ballesterosÁ. González-salamancaA. G. JimenezF. P. HuertaJ. C. J. S. DiazE. B. LopezD. D. L. MoyaA. A. T. AlfonsoP. S. E. LuisP. S. CesarS. I. RafaelC. G. VirgilioN. N. RecioR. O. AdamssonC. C. RylanderB. HolzgraefeL. M. BromanJ. WessberghL. PerssonF. SchiölerH. KedelvA. O. TibblinH. AppelbergL. HedlundJ. HellebergK. E. ErikssonR. GlietschN. LarssonI. NygrenS. L. NunesA. -K. MorinT. KanderA. AdolfssonL. PiquilloudH. O. ZenderC. Leemann-refondiniS. ElatrousS. BouchouchaI. ChoucheneI. OuanesA. B. SouissiS. KamounO. DemirkiranM. AkerE. ErbabacanI. CeylanN. K. GirginM. OzcelikN. ÜNalB. C. MecoO. O. AkyolS. S. DermanB. KennedyK. ParharL. SrinivasaL. McnameeD. McauleyP. HopkinsC. MellisV. KakarD. HadfieldA. VercueilK. BhowmickS. K. HumphreysA. FergusonR. MckeeA. S. RajD. A. FawkesP. WattL. TwoheyR. R. J. M. ThomasA. MortonV. KadabaM. J. SmithA. P. HormisS. G. KannanM. NamihH. ReschreiterJ. CamsooksaiA. KumarS. RugonfalviC. NuttO. O’neillC. SeasmanG. DempseyC. J. ScottH. E. EllisS. MckechnieP. J. HuttonN. N. Di TomassoM. N. VitaleR. O. GriffinM. N. DeanJ. H. CranshawE. L. WillettN. IoannouS. GillisP. CsabiR. MacfadyenH. DawsonP. D. PreezA. J. WilliamsO. BoydL. O. -R. De GordoaJ. BramallS. SymmondsS. K. ChauT. WenhamT. SzakmanyP. Toth-tarsolyK. H. MccalmanP. AlexanderL. StephensonT. CollyerR. ChapmanR. CooperR. M. AllanM. SimD. W. WrathallD. A. IrvineK. S. ZantuaJ. C. AdamsA. J. BurtenshawG. P. SellorsI. D. WeltersK. E. WilliamsR. J. HessellM. G. OldroydC. E. BattleS. PillaiI. KajtorM. SivashanmugavelS. C. O’kaneA. DonnellyA. D. FrigyikJ. P. CarelessM. M. MayR. StewartT. J. TrinderS. J. HaganM. P. WiseJ. M. ColeC. C. MacfieA. T. DowlingJ. HurtadoN. NinJ. HurtadoE. NuñezG. PittiniR. RodriguezM. C. ImperioC. SantosA. G. FrançaA. EbeidA. DeicasC. SerraA. UppalapatiG. KamelV. M. Banner-goodspeedJ. R. BeitlerS. R. MukkeraS. KulkarniJ. LeeT. MesarJ. O. ShinnD. GomaaC. TainterJ. LeeT. MesarJ. LeeD. J. YeattsJ. WarrenM. J. LanspaR. R. MillerC. K. GrissomS. M. BrownP. R. BauerR. J. GosselinB. T. KitchJ. E. CohenS. H. BeegleR. M. GueretA. TulaimatS. ChoudryW. StiglerH. BatraN. G. HuffK. D. LambT. W. OettingN. M. MohrC. JudyS. SaitoF. M. KheirF. KheirA. B. SchlichtingA. DelsingD. R. CrouchM. ElmasriD. R. CrouchD. IsmailK. R. DreyerT. C. BlakemanK. R. DreyerD. GomaaR. M. BaronC. Q. GrijalbaP. C. HouR. SeethalaI. AisikuG. HendersonG. FrendlS. -K. HouR. L. OwensA. SchomerV. BumbasirevicB. JovanovicM. SurbatovicM. VeljovicLung Safe Investigators And The Esicm Trials Groupsubject
MaleARDSmedicine.medical_treatmentlnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4]ARDS reassessment; ARDS Survival; Berlin criteria ARDS; Persisting ARDS;Critical Care and Intensive Care Medicineassisted ventilation0302 clinical medicineRisk Factors030212 general & internal medicinerisk factor AdultTidal volumecomparative studyeducation.field_of_studyRespiratory Distress SyndromeMortality rateRemission Inductiontidal volumeARDS reassessment; ARDS Survival; Berlin criteria ARDS; Persisting ARDS; Critical Care and Intensive Care MedicineARDS reassessmentartificial ventilationclinical trialimmunosuppressive treatmentadult respiratory distress syndromeMiddle AgedARDS SurvivalMonte Carlo methodmedicine.anatomical_structureclassificationpositive end expiratory pressureCardiologyDisease ProgressionSOFA scoredisease severityFemaleAdultmedicine.medical_specialtyPopulationdisease classificationArticleNO03 medical and health sciencesremissionlength of stayAnesthesiologyInternal medicinemedicinepneumoniaSequential Organ Failure Assessment ScoreHumanshumaneducationAgedMechanical ventilationhospital mortalityLungbusiness.industryRisk Factordisease associationRespiratory Distress Syndrome AdultPersisting ARDSmedicine.diseasemajor clinical studymortalityRespiration Artificialbreathing rate030228 respiratory systemdisease exacerbationBerlin criteria ARDSbusinessdescription
Purpose: To evaluate patients with resolved versus confirmed ARDS, identify subgroups with substantial mortality risk, and to determine the utility of day 2 ARDS reclassification. Methods: Our primary objective, in this secondary LUNG SAFE analysis, was to compare outcome in patients with resolved versus confirmed ARDS after 24 h. Secondary objectives included identifying factors associated with ARDS persistence and mortality, and the utility of day 2 ARDS reclassification. Results: Of 2377 patients fulfilling the ARDS definition on the first day of ARDS (day 1) and receiving invasive mechanical ventilation, 503 (24%) no longer fulfilled the ARDS definition the next day, 52% of whom initially had moderate or severe ARDS. Higher tidal volume on day 1 of ARDS was associated with confirmed ARDS [OR 1.07 (CI 1.01–1.13), P = 0.035]. Hospital mortality was 38% overall, ranging from 31% in resolved ARDS to 41% in confirmed ARDS, and 57% in confirmed severe ARDS at day 2. In both resolved and confirmed ARDS, age, non-respiratory SOFA score, lower PEEP and P/F ratio, higher peak pressure and respiratory rate were each associated with mortality. In confirmed ARDS, pH and the presence of immunosuppression or neoplasm were also associated with mortality. The increase in area under the receiver operating curve for ARDS reclassification on day 2 was marginal. Conclusions: ARDS, whether resolved or confirmed at day 2, has a high mortality rate. ARDS reclassification at day 2 has limited predictive value for mortality. The substantial mortality risk in severe confirmed ARDS suggests that complex interventions might best be tested in this population. Trial Registration: ClinicalTrials.gov NCT02010073. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature and ESICM.
year | journal | country | edition | language |
---|---|---|---|---|
2018-01-01 | Intensive care medicine |