6533b83afe1ef96bd12a6f2e

RESEARCH PRODUCT

Immunocompromised patients with acute respiratory distress syndrome: Secondary analysis of the LUNG SAFE database

Andrea CortegianiFabiana MadottoCesare GregorettiGiacomo BellaniJohn G. LaffeyTai PhamFrank Van HarenAntonino GiarratanoMassimo AntonelliAntonio PesentiGiacomo GrasselliHektor SulaLordian NunciAlma CaniAlan ZazuChristian DelleraCarolina S. InsaurraldeRisso V. AlejandroJulio DaldinMauricio VinzioRuben O. FernandezLuis P. CardonnetLisandro R. BettiniMariano Carboni BissoEmilio M. OsmanMariano G. SettenPablo LovazzanoJavier AlvarezVeronica VillarNorberto C. PozoNicolas GrubissichGustavo A. PlotnikowDaniela N. VasquezSantiago IlutovichNorberto TiribelliAriel ChenaCarlos A. PellegriniMaría G. SaenzElisa EstenssoroMatias BrizuelaHernan GianinettoPablo E. GomezValeria I. CerratoMarco G. BezziSilvina A. BorelloFlavia A. LoiaconoAdriana M. FernandezSerena KnowlesClaire ReynoldsDeborah M. InskipJennene J. MillerJing KongChristina WhiteheadShailesh BihariAylin SevenAmanda KrstevskiHelen J. RodgersRebecca T. MillarToni E. MckennaIrene M. BaileyGabrielle C. HanlonAnders AnemanJoan M. LynchRaman AzadJohn NealPaul W. WoodsBrigit L. RobertsMark R. KolHelen S. WongKatharina C. RissThomas StaudingerXavier WitteboleCaroline BerghePierre A. BulpaAlain M. DiveRik VerstraeteHerve LebbinckPieter DepuydtJoris VermassenPhilippe MeerssemanHelga CeunenJonas I. RosaDaniel O. BeraldoClaudio PirasAdenilton M. RampinelliAntonio P. NassarSergio MatalounMarcelo MoockMarlus M. ThompsonClaudio H. GonçalvesAna Carolina P. AntônioAline AscoliRodrigo S. BiondiDanielle C. FonteneleDanielle NobregaVanessa M. Sales BruneiSuresh ShindheDayangku Hajah Maizatul Aiman Binti Pengiran Haji IsmailJohn LaffeyFrancois BeloncleKyle G. DaviesRob CironeVenika ManoharanMehvish IsmailEwan C. GoligherMandeep JassalErin NishikawaAreej JaveedGerard CurleyNuttapol RittayamaiMatteo ParottoNiall D. FergusonSangeeta MehtaJenny KnollAntoine PronovostSergio CanestriniAlejandro R. BruhnPatricio H. GarciaFelipe A. AliagaPamela A. FaríasJacob S. YumhaClaudia A. OrtizJavier E. SalasAlejandro A. SaezLuis D. VegaEduardo F. LabarcaFelipe T. MartinezNicolás G. CarreñoPilar LoraHaitao LiuHaibo QiuLing LiuRui TangXiaoming LuoAn YouzhongHuiying ZhaoYan GaoZhe ZhaiYe Zheng L.Wei WangLi WenwenLi QingdongRuiqiang ZhengYu WenkuiJuanhong ShenLi XinyuYu TaoLu WeihuaWu YaXiao B. HuangHe ZhenyangLu YuanhuaHui HanFan ZhangRenhua SunHua WangShu H. QinBao ZhuJun ZhaoJian LiuLi BinJing LiuFa C. ZhouLi QiongXing Y. ZhangZhou Li-xinQiang Xin-huaLiangyan JiangYuan GaoXian Y. ZhaoLi YuanLi Xiao L.Chunting WangQingchun YaoYu RongguoKai ChenHuanzhang ShaoBingyu QinQing HuangWei H. ZhuAi HangMa X. HuaLi YiminXu YonghaoDi YuLong L. LingTie QinShou H. WangJunping QinYi HanSuming ZhouMonica VargasJuan Silesky JimenezManuel A. González RojasJaime E. Solis-quesadaChristian M. Ramirez-alfaroJan MácaPeter SklienkaJakob GjedstedAage ChristiansenJonas NielsenBoris VillamaguaMiguel LlanoPhilippe BurtinGautier BuzancaisPascal BeuretNicolas PelletierSatar MortazaAlain MercatJonathan ChellySébastien JochmansNicolas TerziCédric DaubinGuillaume CarteauxNicolas De ProstJean-daniel ChicheFabrice DaviaudMuriel FartoukhGuillaume BarberetJerome BiehlerJean DellamonicaDenis DoyenJean-michel ArnalAnais BriquetSami HraiechLaurent PapazianArnaud FollinDamien RouxJonathan MessikaEvangelos KalaitzisLaurence DangersAlain CombesAu Siu-mingGaetan BéduneauDorothée CarpentierElie ZogheibHerve DupontSylvie RicomeFrancesco L. SantoliSebastien BessetPhilippe MichelBruno GeléePierre-eric DaninBernard GoubauxPhilippe CrovaNga T. PhanFrantz BerkelmansJulio BadieRomain TapponnierJosette GallySamy KhebbebJean-etienne HerbrechtFrancis SchneiderPierre-louis M. DeclercqJean-philippe RigaudJacques DuranteauAnatole HarroisRussell ChabanneJulien MarinCharlene BigotSandrine ThibaultMohammed GhaziMessabi BoukhaznaSalem Ould ZeinJack RichecoeurDaniele M. CombauxFabien GrelonCharlene Le MoalElise SauvadetAdrien RobineVirginie LemialeDanielle ReuterMartin DresAlexandre DemouleDany Goldgran-toledanoLoredana BaboiClaude GuérinRalph LohnerJens KrablerSusanne SchäferKai ZacharowskiPatrick MeybohmAndreas ReskePhilipp SimonHans-bernd F. HopfMichael SchuetzThomas BaltusMetaxia PapanikolaouTheonymfi G. PapavasilopoulouGiannis ZacharasVasilis OurailogloyEleni MouloudiEleni V. MassaEva NagyElectra E. StamouEllada KiourtzievaMarina A. OikonomouLuis AvilaCesar CortezJohanna E. CitalánSameer JogSafal D. SableBhagyesh ShahMohan GurjarArvind K. BaroniaMohammedfaruk MemonRadhakrishnan MuthuchellappanVenkatapura J. RameshAnitha ShenoyRamesh UnnikrishnanSubhal DixitRachana V. RhayakarNagarajan RamakrishnanVallish K. BhardwajHeera MahtoSudha V. SagarVijayanand PalaniswamyDeeban GanesanSeyed Mohammadreza HashemianHamidreza JamaatiFarshad HeidariEdel MeaneyAlistair NicholKarl KnapmanDonall O'croininEimhin DunneDorothy M. BreenKevin ClarksonRola F. JaafarRory DwyerFahd AmirOlaitan AjetunmobiAogan C. O'muircheartaighColin BlackNuala TreanorDaniel CollinsWahid AltafGianluca ZaniMaurizio FusariSavino SpadaroCarlo A. VoltaRomano GrazianiBarbara BrunettiniSalvatore PalmesePaolo FormentiMichele UmbrelloAndrea LombardoElisabetta PecciMarco BotteriMonica SavioliAlessandro ProttiAlessia MatteiLorenzo SchiavoniAndrea TinnirelloManuel TodeschiniSara SherAnna RossiMassimo AntonelliLuca M. MontiniPaolo CasalenaSergio ScafettiGiovanna PanarelloGiovanna OcchipintiNicolò PatronitiMatteo PozziRoberto BiscioneMichela M. PoliFerdinando RaimondiDaniela AlbieroGiulia CrapelliEduardo BeckVincenzo PotaVincenzo SchiavoneAlexandre MolinFabio TarantinoGiacomo MontiElena FratiLucia MirabellaGilda CinnellaTommaso FossaliRiccardo ColomboPierpaolo Terragni Ilaria PattarinoFrancesco MojoliAntonio BraschiErika BorottoAndrea CracchioloDaniela M. PalmaFrancesco RaponiGiuseppe FotiEttore VascottoAndrea CoppadoroLuca BrazziLeda FlorisGiorgio IottiAaron VentiOsamu YamaguchiShunsuke TakagiHiroki MaeyamaEizo WatanabeYoshihiro YamajiKazuyoshi ShimizuKyoko ShiozakiSatoru FutamiSekine RyosukeKoji SaitoYoshinobu KameyamaKeiko UenoMasayo IzawaNao OkudaHiroyuki SuzukiTomofumi HarasawaMichitaka NasuTadaaki TakadaFumihito ItoShin NunomiyaKansuke KoyamaToshikazu AbeKohkichi AndohKohei KusumotoAkira HirataAkihiro TakabaHiroyasu KimuraShuhei MatsumotoUshio HigashijimaHiroyuki HondaNobumasa AokiHiroshi ImaiYasuaki OginoIchiko MizuguchiKazuya IchikadoKenichi NittaKatsunori MochizukiTomoaki HashidaHiroyuki TanakaTomoyuki NakamuraDaisuke NiimiTakeshi UedaYozo KashiwaAkinori UchiyamaOlegs SabelnikovsPeteris OssYoussef HaddadKong LiewSilvio A. ÑAmendys-silvaYves D. Jarquin-badiolaLuis Sanchez-hurtadoSaira S. Gomez-floresMaria MarinAsisclo J. VillagomezJordana LemusJonathan M. FierroMavy Ramirez CervantesFrancisco Javier Flores MejiaDulce DectorDulce M. DectorDaniel GonzalezClaudia R. EstrellaJorge Sanchez-medinaAlvaro Ramirez-gutierrezFernando GeorgeJanet S. AguirreJuan BuensusesoManuel PoblanoTarek DendaneAmine Ali ZeggwaghHicham BalkhiMina ElkhayariNacer SamkaouiHanane EzzouineAbdellatif BenslamaMourad AmorWajdi MaazouziNedim CimicOliver BeckMonique BrunsJeroen A. SchoutenMyra RiniaMonique RaaijmakersLeo HeunksHellen M. Van WezelSerge HeinesUlrich StrauchMarc BuiseFabienne SimonisMarcus J. SchultzJennifer GoodsonTroy S. BrowneLeanlove NavarraAnna HuntRobyn HutchisonMathew B. BaileyLynette NewbyColin McarthurMichael KalkoffAlex McleodJonathan CasementDanielle J. HackingFinn AndersenMerete S. DolvaJon LaakeAndreas Barratt-dueKim Andre NoremarkEldar SøreideBrit A. SjøbøAnne B. GuttormsenHector Leon YoshidoRonald Zumaran AguilarFredy A. Montes OscanoaAlain AlisasisJoanne B. RoblesRossini Abbie Pasanting-limBeatriz C. TanPawel AndruszkiewiczKarina JakubowskaCristina CoxoAntónio AlvarezBruno S. OliveiraGustavo MontanhaNelson C. BarrosCarlos PereiraAntónio M. MessiasJorge MonteiroAna AraujoNuno T. CatorzeSusan MarumMaria J. BouwRui GomesVania A. BritoSilvia CastroJoana M. EstilitaFilipa BarrosIsabel Serra AureliaDana TomescuAlexandra MarcuOvidiu BedreagMarius PapuricaDan CorneciSilvius Ioan NegoitaEvgeny GrigorievAlexey GritsanAndrey A. GazenkampfGhaleb AlmekhlafiMohamad M. AlbarrakGhanem M. MustafaKhalid MaghrabiNawal SalahuddinTharwat AisaAhmed Al JabbaryEdgardo TabhanYaseen M. ArabiOlivia A. TrinidadHasan M. Al DorziEdgardo E. TabhanStefan BolonOliver SmithJordi ManceboHernan Aguirre-bermeoJuan Lopez-delgadoFrancisco EsteveGemma RialpCatalina FortezaCandelaria De HaroAntonio ArtigasGuillermo AlbaicetaSara De Cima-iglesiasLeticia Seoane-quirogaAlexandra Ceniceros-barrosAntonio Ruiz-aguilarLuis M. Claraco-vegaJuan Alfonso SolerMaria Del Carmen LorenteCecilia HermosaFederico GordoMiryam Prieto-gonzálezJuan B. López-messaManuel PerezCesar P. PerezRaquel Montoiro AllueFerran Roche-campoMarco Ibañez-santacruzSusana TempranoMaria PintadoRaul De PabloPilar Ricart Aroa GómezSilvia Rodriguez RuizSilvia Iglesias MolesMaria Teresa JuradoAlfons ArizmendiEnrique PiacentiniNieves FrancoTeresa HonrubiaMeisy Perez ChengElena Perez LosadaJavier BlancoLuis J. YusteCecilia Carbayo-gorrizFrancisca G. Cazorla-barranqueroJavier AlonsoRosa S. AldaÁNgela AlgabaGonzalo NavarroEnrique CereijoEsther Diaz-rodriguezDiego Pastor MarcosLaura Alvarez MonteroLuis Herrera ParaRoberto Jimenez SanchezMiguel Angel Blasco NavalpotroRicardo Diaz AbadRaquel Montiel GonzálezDácil Parrilla ToribioAlejandro CastroMaria Jose D. ArtigaOscar PenuelasTomas RoserMoreno F. OlgaElena Gallego CurtoRocío Manzano SánchezVallverdu ImmaGarcia M. ElisabetLaura ClaveriasMonica MagretAna PellicerLucia L. RodriguezJesús Sánchez-ballesterosÁNgela González-salamancaAntonio JimenezFrancisco P. HuertaJuan Carlos Sotillo DiazEsther Bermejo LopezDavid Llinares MoyaAlec A. Tallet AlfonsoPalazon Sanchez Eugenio LuisPalazon Sanchez CesarSánchez I. RafaelCorcoles G. VirgilioNoelia RecioRichard AdamssonChristian C. RylanderBernhard HolzgraefeLars M. BromanJoanna WessberghLinnea PerssonFredrik SchiölerHans KedelvAnna Oscarsson TibblinHenrik AppelbergLars HedlundJohan HellebergKarin ErikssonRita GlietschNiklas LarssonIngela NygrenSilvia NunesAnna-karin MorinThomas KanderAnne AdolfssonLise PiquilloudHervé ZenderCorinne Leemann-refondiniSouheil ElatrousSlaheddine BouchouchaImed ChoucheneIslem OuanesAsma Ben SouissiSalma KamounOktay DemirkiranMustafa AkerEmre ErbabacanIlkay CeylanNermin Kelebek GirginMenekse OzcelikNecmettin ÜNalBasak Ceyda MecoOnat AkyolSuleyman S. DermanBarry KennedyKen ParharLatha SrinivasaLia McnameeDanny McauleyPhil HopkinsClare MellisVivek KakarDan HadfieldAndre VercueilKaushik BhowmickSally K. HumphreysAndrew FergusonRaymond MckeeAshok RajDanielle A. FawkesPhilip WattLinda TwoheyRajeev JhaMatthew ThomasAlex MortonVarsha KadabaMark SmithAnil P. HormisSanthana KannanMiriam NamihHenrik ReschreiterJulie CamsooksaiAlek KumarSzabolcs RugonfalviChristopher NuttOrla OneillColette SeasmanGed DempseyChristopher ScottHelen E. EllisStuart MckechniePaula J. HuttonNora Di TomassoMichela N. VitaleRuth GriffinMichael N. DeanJulius CranshawEmma L. WillettNicholas IoannouSarah GillisPeter CsabiRosaleen MacfadyenHeidi DawsonPieter PreezAlexandra J. WilliamsOwen BoydLaura Ortiz-ruiz De GordoaJon BramallSophie SymmondsSimon ChauTim WenhamTamas SzakmanyPiroska Toth-tarsolyKatie MccalmanPeter AlexanderLorraine StephensonThomas CollyerRhiannon ChapmanRaphael CooperRussell AllanMalcolm SimDavid WrathallDonald A. IrvineKim ZantuaJohn C. AdamsAndrew BurtenshawGareth P. SellorsIngeborg WeltersKaren E. WilliamsRobert HessellMatthew G. OldroydCeri BattleSuresh PillaiIstvan KajtorMageswaran SivashanmugavelSinead OkaneAdrian DonnellyAniko FrigyikJon P. CarelessMartin MayRichard StewartT. John TrinderSamantha J. HaganMatt WiseJade M. ColeCaroline MacfieAnna T. DowlingJavier HurtadoNicolás NinEdgardo NuñezGustavo PittiniRuben RodriguezMaría C. ImperioCristina SantosAna FrançaAlejandro EbeidAlberto DeicasCarolina SerraAditya UppalapatiGhassan KamelValerie Banner-goodspeedJeremy R. BeitlerSatyanarayana Reddy MukkeraShreedhar KulkarniJarone LeeTomaz MesarChristopher TainterJohn O. Shinn IiiDina GomaaDale YeattsJessica WarrenMichael LanspaRussel R. MillerColin K. GrissomSamuel M. BrownPhilippe BauerRyan GosselinBarrett T. KitchJason CohenScott H. BeegleShazia ChoudryRenaud GueretAiman TulaimatWilliam StiglerHitesh BatraNidhi HuffKeith LambTrevor W. OettingNicholas MohrClaine JudyShigeki SaitoFayez M. KheirFayez KheirAdam SchlichtingAngela DelsingDaniel CrouchMary ElmasriDina IsmailKyle DreyerThomas C. BlakemanRebecca BaronCarolina Quintana GrijalbaPeter HouRaghu SeethalaImo AisikuGalen HendersonGyorgy FrendlSen-kuang HouRobert L. OwensAshley SchomerVesna BumbasirevicBojan JovanovicMaja SurbatovicMilic VeljovicGuy FrancoisFrancesca RabboniSara ContiFernando RiosT. SottiauxP. DepuydtFredy LoraLuciano Cesar AzevedoEddy FanGuillermo BugedoMarcos GonzalezJuan SileskyVladimir CernyManuel JibajaHermann WriggeDimitrios MatamisJorge Luis RaneroPravin AminS. M. HashemianKevin ClarksonKiyoyasu KurahashiAsisclo VillagomezJose Emmanuel PaloAntero Do Vale FernandesDorel SandescYaasen ArabiVesna BumbasierevicJose A. LorenteAnders LarssonFekri AbrougDaniel McauleyEd BajwaGabriel Démpair

subject

MaleARDSmodelos logísticosDatabases Factualmedicine.medical_treatment[SDV]Life Sciences [q-bio]humanoslnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4]Kaplan-Meier EstimateCritical Care and Intensive Care MedicineAcute respiratory failureSeverity of Illness IndexCohort Studiesrandomized-trial0302 clinical medicineMechanical ventilationRisk Factorsestudios prospectivosEpidemiology80 and overicuMedicineProspective StudiesProspective cohort studyestudios de cohortesImmunodeficiencymediana edadestadísticasAged 80 and overRespiratory Distress Syndromeancianocritically-ill patientsRespirationresultado del tratamientorespiraciónStatisticslcsh:Medical emergencies. Critical care. Intensive care. First aidadultoMiddle Aged3. Good healthfailureIntensive Care UnitsTreatment OutcomeArtificialCohortprospective multicenterImmunocompromised patientsAcute respiratory failure; ARDS; Immunocompromised patients; Mechanical ventilation; Noninvasive ventilation; Critical Care and Intensive Care MedicineFemaleNoninvasive ventilationHumanestimación de Kaplan-MeierAdultmedicine.medical_specialtyLogistic ModelIntensive Care UnitSocio-culturaleunidades de cuidados intensivossurvivalStatistics NonparametricSepsisDatabases03 medical and health sciencesImmunocompromised HostInternal medicineImmunocompromised patientcancerfactores de riesgoHumansNonparametricíndice de gravedad de la enfermedadintensive-care-unitFactualAgedMechanical ventilationbusiness.industryResearchRisk FactorRespiratory Distress Syndrome Adult030208 emergency & critical care medicinelcsh:RC86-88.9medicine.diseaseRespiration ArtificialPneumoniaProspective StudieLogistic Models030228 respiratory systemmalignanciesARDShuésped inmunodeprimidoCohort StudiebusinessAcute respiratory failure; ARDS; Immunocompromised patients; Mechanical ventilation; Noninvasive ventilation; Adult; Aged; Aged 80 and over; Cohort Studies; Databases Factual; Female; Humans; Intensive Care Units; Kaplan-Meier Estimate; Logistic Models; Male; Middle Aged; Prospective Studies; Respiration Artificial; Respiratory Distress Syndrome Adult; Risk Factors; Severity of Illness Index; Statistics Nonparametric; Treatment Outcome; Immunocompromised Host

description

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 noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p < 0.0001), despite similar severity of ARDS. Decisions regarding limiting life- sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p < 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge.

yearjournalcountryeditionlanguage
2018-06-12
10.1186/s13054-018-2079-9http://hdl.handle.net/11591/420125