5 research outputs found
Intradural Extramedullary Plasmacytoma in a Dog
- Author
- Publication venue
- 'Universidade Federal do Rio Grande do Sul'
- Publication date
- 01/01/2020
- Field of study
Background: Plasmacytoma is a neoplasm originating in plasma cells, derived from B lymphocytes. Extramedullary presentation is the most common form of plasmacytoma, mainly in the skin and rarely in other tissues, including the vertebral canal. Extramedullary plasmacytoma (EMP) occurs more frequently in senile dogs and rarely in cats and some dog breeds have predisposition for this type of neoplasm. The aim of this study was to report plasmacytoma in a dog located adjacent to the thoracic vertebrae.Case: An approximately 5-year-old mongrel male with sudden paraplegia resulting from upper motor neuron injury was admitted to a University Hospital. The dog presented a six-centimeter diameter mass in the dorsal region, adjacent to the thoracic vertebrae. The leucogram presented mild leukopenia by eosinopenia and lymphopenia. Myelogram associated with epidurography showed a fill failure in the contrast column between the seventh and ninth thoracic vertebrae, and there were no osteolysis points in the thoracic vertebrae, adjacent to the neoplastic mass. The evaluation of the intervertebral spaces between the fourth to ninth thoracic vertebrae presented no increase in radiopacity, nor alterations in the size of intervertebral spaces, indicating intervertebral disc extrusion. The laterolateral radiographs showed an alignment of the vertebrae and vertebral canal, without presence of bone neoformations on the ventral face of the vertebral bodies. The animal was euthanized and fragments of mass were collected for histological analysis. Macroscopic findings presented a non-encapsulated well-delimited mass, with color ranging from white to reddish. Microscopically, there was proliferation of moderately differentiated round cells in bone and muscle tissues, arranged in mantle, with moderately eosinophilic cytoplasm, and rounded nucleus with eccentric location, coarse chromatin sometimes indistinct. These cells presented moderate anisocytosis and, in general, one mitosis per field. Intradural extramedullary plasmacytoma was diagnosed.Discussion: The present report presented a diagnosis of intradural EMP, generating compression of the spinal cord because of its invasive growth, reaching the canal and, thus, reducing its lumen. The clinical status of the dog was compatible with thoracolumbar lesion of upper motor neuron, which causes paresis and ataxia in pelvic limbs. In this case, it was not possible to establish early diagnosis because the dog had been rescued from the streets recently. Radiographic examination was important to identify the real size of the mass, and the myelography confirmed spinal cord compression. The definitive diagnosis was obtained by histological examination. Although extramedullary plasmacytoma is a low-frequency neoplasm, in the present report, its manifestation was atypical, more aggressive, invading the medullary canal and compressing the spinal cord. Spinal cord compression may lead to degeneration of axons because of alterations in the vascular permeability associated with local inflammatory process, reducing the oxygen supply to nervous tissues, resulting in cellular degeneration. The occurrence of atypical neoplastic growth should be included as a differential diagnosis for lesions in upper motor neuron in cases of spinal cord compression. This is an atypical location for this kind of neoplasia, and cases of medullary compression of neoplastic masses should be included as a differential diagnosis
Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Diseaseâ
- Author
- Abderrahim Azzouzi
- Abroug F.
- Achille Kouatchet
- Achim Lunkeit
- Adam Mikstacki
- Aguilera GarcĂa
- Ahmed Sbihi
- Ai-Chin Cheng
- Ainhoa RossellĂł
- Alain Mercat
- Alan Javier Zazu
- Alberto Belenguer
- Alberto Deicas
- Alberto Marino
- Alberto Soler
- Alejandro Algora
- Alejandro Arroliga
- Alejandro de la Serna
- Alejandro GĂłmez
- Alejandro Raimondi
- Alejandro Risso
- Alfonso Moreno
- Alfonso Muñoz
- Alfredo PadrĂłn
- Alfredo Vasquez-Sandoval
- Ali Aydım Altunkan
- Ali Zeggwagh A.
- Aline Camile Yehia
- Alistair Nichol
- Allan Walkey
- Allison Bone
- AloĂsio Marques do Nascimento
- Alvaro van Bommel
- Amalia MartĂnez de la Gandara
- Amber Monson
- Ambrogio Sansone
- Amee Patrawalla
- Amin P.
- Amine Ali Zeggwagh
- Amparo Ferrandiz
- Amy Waters
- Ana Carolina Caballero
- Ana Esther Trujillo
- Ana VillagrĂĄ
- Anders Aneman
- Andrea Gimenez
- Andrea Matte
- Andrea Neville Cracchiolo
- Andreas Schwartz
- Andreas Viehöfer
- Andrei Piontek
- Andrew Bersten
- Andrew Davies
- Andrew Davies
- Andrew Davies
- Andrew Steel
- Andrey Yaroshetskiy
- Anette Mortensen
- Anitha Shenoy
- Ankur Devendra Bhavsar
- Annunziata Mattei
- Anthony Saleh
- Antonina Pigna
- Antonino Giarratano
- Antonio Anzueto
- Antonio Braschi
- Antonio Corcione
- Antonio GarcĂa-JimĂ©nez
- Antonio Maestre
- Antonio Pesenti
- Antonio Raso
- Antonio Reyes
- Antonio Villa Delgado
- Antonio Viñuales
- Anzueto A.
- Arianna Boggero
- Ariel Chena
- Armando Pedulla'
- Arnaud W Thille
- Ashley Ellis
- Ashley Ellis
- Asisclo J VillagĂłmez Ortiz
- Auke Reidinga
- Ayed Samia
- Barbara Tamowicz
- Barrios D.
- Bas M Kors
- Begoña Balerdi
- Benoit Veber
- BernabĂ© Ălvarez
- Bersten A.
- Bert Beishuizen
- Besbes Mohamed
- Bilge Ăetin
- Bin Du
- Bin Du
- Bin Yu
- Bing Sun
- Birgitte Viebaek
- Bladimir Alejandro Gil
- Bo Broberg
- Bo Wang
- Boris Villamagua
- Brian Sherman
- Bruno Bonaccorsi Fernandino
- Bruno do Valle Pinheiro
- Bryan Beatty
- C Canevet
- Cakar N.
- Cameron Knott
- Camilo Pizarro
- Carlo Alberto Acosta
- Carlos Alberto Studart Gomes
- Carlos André Correia Casado
- Carlos AndrĂ©s DĂaz
- Carlos Gallego
- Carlos Marian Crespo
- Carlos Robles-Arias
- Carmelo Dueñas
- Carmen Campos
- Carolina GĂmenez-Esparza
- Carolina Lorencio
- Cartan Costello
- Catherine Simmonds
- Cayce Strength
- Cayetano Galetti
- Cecilia Carbayo
- Cecilia Hermosa
- Cecilia Pereyra
- Cesar Enciso
- Cezar Mihailescu
- Chabu Coronado
- Chafrina Marie Olay
- Chang Liu
- Chantal Hogan
- Charki Haimeur
- Chau Chin Man
- Chen Chin-Ming
- Chengmin Yu
- Cheromi Sittambalam
- Cheryl Cuzner
- Cheryl Ethier
- Chiara Verga
- Christian Frenkel
- Christian Putensen
- Christopher MacIsaac
- Christopher Spradley
- Chuanyun Qian
- Claire Cattigan
- Claire Reynolds
- Clara Laplaza Eva Regidor
- Clara Pacheco
- Claudia Diaz
- Claudia Olvera-Guzman
- Craig A Piquette
- Craig Cernosek
- Crissie De Spirito
- Crissie Despirito
- Cristian Casabella
- Cristian Cevallos
- Cristina Orlandi
- Cristina Santos
- CĂ©sar Antonio Maquilon
- CĂ©sar AragĂłn
- CĂ©sar Cruz Lozano
- CĂ©sar PĂ©rez-Calvo
- Damian Violi
- Dana K Soetaert
- Daniel Duarte
- Daniel Fontaneda
- Daniel Vargas
- Daniel Weiss
- David Freire
- David Milliss
- Davide Chiumello
- Daxing Yu
- Debiao Song
- Deborah Barge
- Deborah Cook
- Deepak Govil
- Del-Sorbo L.
- Denice Wells
- Dennis Bergmans
- Dhruva Chaudhry
- Di Russo
- Diane Mackle
- Dianne Hill
- Dianne Stephens
- Dietrich Henzler
- Dimitros Matamis
- Dimple Tejwani
- Dinalva Aparecida Gomes
- Do Danh Quynh
- Dolores Vila
- Dongpo Jiang
- Dorothée Carpentier
- Du B.
- Edgard Luna
- Edgardo E Tabhan
- Edgardo Nuñez
- Edoardo De Robertis
- Eduard Bootsma
- Eduardo Almeida
- Eduardo Fonseca Sad
- Edward Nicolayenko
- Eileen Gilder
- Elena Gallego
- Elena Parreño
- Eleni Antoniadou
- Elias Caragna
- Elisa Estenssoro
- Elisha Fulton
- Elisha Matheson
- Ellen Kinkel
- Emily Stern
- Enrique MaravĂ
- Enrique Piacentini
- Erika Mannelli
- Erin Braden
- Erna Alberts
- Erwin J Oei
- Esteban A
- Eugenio PalazĂłn
- Eva Benveniste
- Eva Manteiga
- Fabien Grelon
- Fabien Soulis
- Fabricio Picoita
- Fachun Zhou
- Falk Hildebrandt
- Fang Xu
- Farhad N Kapadia
- Fausto Fialho Moura
- Federica Antonicelli
- Federica Tallarini
- Federico Gordo
- Fekri Abroug
- Feng Li
- Fernando AntĂŽnio Botoni
- Fernando FernĂĄndez
- Fernando Lambert
- Fernando Lipovestky
- Fernando PĂ©rez
- Fernando RĂos
- Fernando Saldarini
- Fernando SĂĄnchez
- Fernando Villarejo
- Fernando Villarejo
- Filomena Faria
- Forbes McGain
- Francesca Frigieri
- Francesco Idone
- Francesco Mojoli
- Francisco Criado
- Francisco Guerrero
- Francisco Lucena
- Francisco Manzano
- Francisco Molina
- Francisco Ortuño
- Frank Torres
- Franklin Villegas
- François Collet
- Freddy Sandy
- Freddy SĂĄnchez
- Frederico Costa Val Barros
- Frederico Rodrigues Anselmo
- Frutos-Vivar F.
- Frédéric Bellec
- FĂ©lix Lacoma
- Gabriel D Empaire
- Gaetano Perchiazzi
- Gang Li
- Gary Kinasewitz
- Gary Kinasewitz
- GastĂłn Pittini
- Gaëtan Bedunaeu
- Gee Young Suh
- Gemma Rialp
- Geneva Tatem
- Geng Zhang
- Genis Carrasco
- George Liziamma
- George Lukas
- Gerardo Filippa
- Gilda Diaz-Fuentes
- Gina Quinde
- Giorgia Citterio
- Giorgio Tulli
- Gonzalez M.
- Gonzalo Javier RĂos
- Graciela Elizabeth
- Graciela Franca
- Graeme Duke
- Gregory A Schmidt
- Guillaume Marcotte
- Guillermo Chiappero
- Guillermo Cueto Robledo
- Guillermo FalconĂ
- Guillermo Muñiz
- Guillermo Ortiz
- Gustavo Badariotti
- Gustavo Jannello
- Gustavo Morales Muñoz
- Gustavo Paredes
- GĂ©raldine Dessertaine
- Haibo Qiu
- Hannah Mathers
- Hans-Henrik BĂŒlow
- Harald Fritz
- Harry P P M Gelissen
- Heinrich Paulus
- Heinz Kerger
- Helen Rodgers
- Helen Wong
- Heloisa Castro
- Henry Caballero
- Hergen Buscher
- Hernan Nunia
- Hernån Nuñez
- Hong Pu
- Hongyang Xu
- Hongyuan Lin
- Howard Connor
- Hugo Capponcelli
- Hugo Urbano
- Hye Sook Choi
- Ian Carrasco
- Ian Moore
- Ian Seppelt
- Ilaria Curro'
- Ilaria Maria Mastromauro
- Imed Chouchene
- Imogen Mitchell
- Ingrid van den Hul
- Ingrid Von der Osten
- Inmaculada VallverdĂș
- Irene AragĂŁo
- Irene Dot
- Irene Watpool
- Islem Ouanes
- Ismail Kati
- Itziar Mintegui
- Ivano Aprile
- Jacinto Baena
- Jackeline Coello
- Jan Dittmann
- Jan Friedrich
- Jan Mehrtens
- Jane Thomas
- Janine Dias Alves
- Jasmin Board
- Jasmin Board
- Jasmin Board
- Jason Fletcher
- Javier Blanco
- Javier Castañeda
- Javier CebriĂĄn
- Javier DĂaz DomĂnguez
- Javier GarcĂa-Alonso
- Javier GonzĂĄlez-Robledo
- Javier Horacio Ălvarez
- Javier Hurtado
- Javier Ladape Martinez
- Javier Ruiz
- Je Hyeong Kim
- Jean-Christophe M Richard
- Jeff Presneill
- Jeffrey Singh
- Jennifer Germain
- Jennifer Goodson
- Jennifer Holmes
- Jennifer Twombley
- Jenny Dennett
- Jens Brushoj
- Jens Buettner
- JesĂșs SĂĄnchez
- JesĂșs SĂĄnchez-Ruiz
- Jian Huang
- Jianbiao Meng
- Jianguo Li
- Jianhong Fu
- Jianying Guo
- Jiaqiong Li
- Jibaja M.
- Jin Hwa Lee
- Jin Young An
- Jinghua Wang
- Jiuzhi Zhang
- Joachim Hartung
- Joan Maria Raurich
- Joana Silvestre
- Joanne Sutton
- Jodi Brown
- Johannes Busch
- John Durning
- John Myburgh
- John Oropell
- John Santamaria
- Jorge Arroyo
- Jorge Gerez
- Jorge Vidal HernĂĄndez
- Jorgelina Guyon
- Jose Angel Baltazar Torres
- Josep Maria Sirvent
- José Carlos Versiani
- José Claudio Leo
- José Elizalde
- José Francisco López Baca
- José J Blanco
- José Luis Scapellato
- José Manuel Serrano
- JosĂ© MarĂa GutiĂ©rrez
- JosĂ© MarĂa MontĂłn
- JosĂ© MarĂa NicolĂĄs
- JosĂ© MarĂa Quiroga
- José Miguel Guerrero
- José Salinas
- JosĂ© Salvador MartĂnez Cano
- Joyce Okahashi
- Juan Carlos
- Juan Carlos Maurelia
- Juan David Uribe
- Juan Diego Jiménez
- Juan Domingo FernĂĄndez
- Juan Guerra
- Juan Pablo Sedano
- Juan Ramón Cortés
- Juanxian Gu
- Judi Tai
- Judith SagardĂa
- Julia LĂłpez-DĂaz
- Julian Strati
- Julie Smith
- Julio Osorio
- Julio Pontet
- JuliĂĄn HernĂĄndez
- Jun Jin
- Jörg Haberkorn
- Jörn Schlechtweg
- Karina Bonasegla
- Katherine Davidson
- Kathleen Lilli
- Katty Trelles
- Kelly Choy
- Kerry Canady
- Ki-Suck Jung
- Kim Heus
- Konstantinos Raymondos
- Kwan Ming Chit
- Kyung Chan Kim
- Larry Welder
- Laura Jones
- Laura Sayagues
- Laura Wilson
- Laura Ălvarez-Montero
- Lauralyn McIntryre
- Laurent Brochard
- Leanne Boehm
- Lei Chen
- Leila Eckholt
- Leonardo Pazmiño
- Leonie Weisbrodt
- Leticia Rapetti
- Liang Pan
- LidĂłn Mateu
- Liliana Caipe
- Lisa Julien
- Lisandro Betttini
- Loredana Pitagora
- Lori-Ann Kozikowski
- Lucas Vallejo
- Lucia Capilla
- Luis Fernando Castro Castro
- Luis Gonzalez Mosquera
- Luis GonzĂĄlez Zambrano
- Luis Marina
- Luis Pablo Cardonnet
- Luis Soto-Germani
- Luis Soto-RomĂĄn
- Luis Williams
- Lutz Pfeiffer
- Lynette Newby
- M Eugenia
- Madhav Gudi
- Madison Dennis
- Maggiore S. M.
- Manoj K Saxena
- Manuel Jibaja
- Manuel Valledor
- Maoqin Li
- Mar Gobernado
- Marc Fabra
- Marc Lipkus
- Marcela Canola-Mazo
- Marcela Granados
- Marcelo AlcĂąntara Holanda
- Marcelo Choque
- Marcelo Ochoa
- Marcelo Palavecino
- Marco Adversi
- Marco AntĂŽnio Ribeiro LeĂŁo
- Marco AntĂŽnio Soares Reis
- Marco Bezzi
- Marco Escobar
- Marco Gonzalez
- Marco GonzĂĄlez
- Marco Montes De Oca
- Marcos Delgado
- Marcos Juan Zec
- Marcus Ruecker
- Maria Aparecida Braga
- Maria Del Mar Torres-Perez
- Maria Giannakou
- Maria Wussow
- Mariana Monllau
- Marianna Esposito
- Marin M. D. C.
- Marina Busico
- Mario Acosta
- Mario Alonso Treviño Salinas
- Mario Cancela
- Mario GĂłmez
- Mario Villabon
- Marisol RodrĂguez-Goñi
- Mark Bailey
- Mark Tidswell
- Markus Schappacher
- Marta Beron
- Marta Ferrari
- Marta Ugalde
- Martin Deheza
- MartĂn Lugaro
- Mary La Pine
- MarĂa BelĂ©n Yapur
- MarĂa Del Carmen de la Torre
- MarĂa Elena PĂ©rez-Losada
- MarĂa Eugenia GonzĂĄlez
- MarĂa Fernanda GarcĂa
- MarĂa Garitacelaya
- MarĂa Isabel Ruiz
- MarĂa JosĂ© TolĂłn
- MarĂa Luisa Navarrete
- MarĂa Victoria de la Torre
- MarĂa Ăngeles Alonso
- MarĂa Ăngeles Pena
- Matamis D.
- Matthew Kirchner
- Matty Koopmans
- MatĂas Brizuela
- Mauricio Vinzio
- Maurizio Bottiroli
- Maurizio Raineri Santi
- MaurĂcio Meireles GĂłes
- Maximillian Ragaller
- Mayur Patel
- Medhat Soliman
- Mehar-Un-Nisa Raja
- Mian Chen
- Michael A Kuiper
- Michael Miletin
- Michael Quintel
- Michela Bombino
- Michele Iannuzzi
- Miguel FernĂĄndez-Vivas
- Miguel Lazcano
- Miguel LeĂłn
- Miguel Llano
- Miguel Ăngel GonzĂĄlez-Gallego
- Mijail JĂĄtiva
- Mikhail Kirov
- Mikkel PrĂŠst
- Minka Springham
- Miquel Ferrer
- Mirko Belliato
- Mohamed A Saad
- Mohammed Al-Jagbeer
- Monica Rocco
- Monika Holler
- Moo Suk Park
- Mounir Bouaziz
- Mourad Amor
- Muriel A.
- Myriam Montalvo
- Myung-Goo Lee
- Nagarajan Ramakrishnan
- Nahit Cakar
- Neill Adhikari
- Nelson Barros
- Nelson Fonseca
- Nelson Medina
- Nghuyen Ba Tuan
- Nguyen Huu Hoang
- Niall Ferguson
- Nicolas Nin
- Nicole Marinoff
- NicolĂĄs Zamboschi
- Nieves Franco
- Nils Marquardt
- Nin N.
- Norberto Tiribelli
- Norberto Tiribelli
- Norma Beatriz MĂĄrquez
- Nuria Alonso
- Oliver Franke
- Olivia Dulfo
- Orla Smith
- Oscar Cluzet
- P Kruska
- P Samaddar
- Pablo Desmery
- Pablo GĂłmez
- Pang Wing Yan
- Paolo Navalesi
- Pascal Beuret
- Pascual Valdez
- Patricia Albert
- Patricia Jimeno
- Patricia Leung
- Patricia Vogl
- Paul Goldrick
- Paul J Dennesen
- Paul Young
- Paulo Marcal
- Pedro Alzugaray
- Pedro Galdos
- Pedro JesĂșs DomĂnguez
- Pedro Rosa
- Pelosi P.
- Penuelas O.
- Pertsas Evangelos
- Peter van der Voort
- Pham Thi Van Anh
- Phil Alkana
- Philippe Berger
- Pierre-Gildas Guitard
- Prachee Sathe
- Pravin Amin
- Priya Nair
- Qing Song
- Qingyuan Zhan
- Qunmei Yao
- Rachael Parke
- Rachel Whyte
- Rafael Blancas
- Rafael Morales
- Rahul Nanchal
- Raju Pusapati
- Ramiro Puetate
- Raquel Manzanedo
- Raquel Montoiro
- Raquel Yano
- Raymondos K.
- RaĂșl de Pablo
- RaĂșl GonzĂĄlez
- RaĂșl Lombardi
- Remzi Iscimen
- Ricardo Buitrago
- Ricardo Martinez Zubieta
- Ricardo Matos
- Rick McAllister
- Rios F.
- Robba C.
- Robert Fowler
- Robyn Klages
- Rodrigo E GĂłmez-Paz
- Roger Lamoglie
- Rogério de Castro Pereira
- Roland Schneider
- Rolf Dembinski
- Rolf Rossaint
- Rollin RoldĂĄn Mori
- Romano Tetamo
- RomĂĄn Garrido
- Ronald Pairumani
- Ronnie Mantilla
- Rosa Luz LĂłpez MartĂnez
- Rosa SebastiĂĄn
- Rosa Ălvaro
- Rosalba Tufano
- Rosanna Del Giudice
- Rosanna Vaschetto
- Rosario Urbino
- RovĂlson Lara
- RovĂlson Lara
- Rubens Altair Amaral de PĂĄdua
- Rubén Camargo
- Rui Moreno
- Rupesh Vakil
- Ryan Albert
- Sabriye Guvenc
- Salem Ould Zein
- Salvatore Maurizio Maggiore
- Samer Haj-Bakri
- Samir Abdelhadi
- Samir Sahu
- Samir Vermani
- Sando Chavarria
- Sangeeta Mehta
- Sanjay Dhanuka
- Santiago Ilutovich
- Sara Cabañes
- Schimdt Alejandra
- Sebastian Circo
- SebastiĂĄn E Mare
- Serena Azzari
- Serge Heines
- Sergio CĂĄceres
- Sergio Lasdica
- Seton Henderson
- Shawna Reddie
- Sheila Nainan Myatra
- Shelby Sutton
- Sheree Gare
- Shirley Nelson
- Shouhong Wang
- Silke Frenzel
- Silvia Mareque
- Silvina Borello
- Silvio A Ăamendys-Silva
- Simon J G Hockley
- Simona Beniczky
- Sindhaghatta Venkatram
- Sine Wichman
- Smyth Smith
- Soares M. A.
- SofĂa GarcĂa
- Soraya Puertas
- Srinivas Samavedam
- Stambouli Neji
- Steffen Appel
- Steffen Weber-Carstens
- Stephanie Lubchansky
- Stephen Lapinsky
- Steven Y Chang
- Stevens Salva
- Subhash Kumar Todi
- Sujoy Mukherjee
- Susan Gillen
- Susana Alves Ferreira
- Susana Moradillo
- Susana Temprano
- Susanne Andi Iversen
- Sutherasan Y.
- Sutrisno Gunawan
- Sylvia den Boer
- Tania Caf
- Tarek Dendane
- Tayfun Adanir
- Tejerina E. E.
- Teresa Mut
- Teresa SĂĄnchez de Dios
- Thille A. W.
- Thomas Bein
- Thomas Lipp
- Thomas Moellhoff
- Thomas Steinke
- Thoralf Kerner
- Tiehe Qin
- Tim Coles
- Tim Houlihan
- Timothy D Girard
- Tom Cowlam
- Tony Sutherland
- Tony Williams
- Travis Parry
- Troy Browne
- Tumbass Volker
- Uli Strauch
- Umesh G
- Unase BĂŒyĂŒkkoçak
- V J Cardenas Jr
- ValentĂn Parra
- Valerio Mangani
- Valery Subbotin
- Valle Pinheiro B.
- Valéria de Carvalho Magela
- Vanesa RamĂrez
- Vicente Arraez
- Victoria Goñi
- Vincent John Scott
- Vito Marco Ranieri
- Vivek Joshi
- Wajdi Maazouzi
- Walter Brandt
- Walter Seyde
- Wanxia Li
- Wei He
- Wei Yu
- Wei Zhang
- Weihai Yao
- William Rodriguez-Cintron
- Winfried Schubert
- Wolfgang Baier
- Won-Yeon Lee
- Xi Zhu
- Xianyao Wan
- Xiaobo Huang
- Xue Wang
- Yalin Liu
- Yan Kang
- Yangong Chao
- Yaseen Arabi
- Yi Li
- Yi Yang
- Yogeet Kaur
- Yongjie Yin
- Young Suh G.
- Younsuck Koh
- Yu Bai
- Yuan Xu
- Yuhong Guo
- Yun Seong Kim
- Yunxuan Yue
- Zafer Dogan
- Zalatiel Maycotte Luna
- Zaza Cohen
- Zhengxuan Lv
- Zhenjie Hu
- Zhenyang He
- Zhicheng Zhang
- Zhihua Hu
- Zhixiang Li
- Zoltan Szentkereszty
- Zoraida Parra
- Zsolt Molnar
- Ăngela Alonso
- Publication venue
- 'Ovid Technologies (Wolters Kluwer Health)'
- Publication date
- 01/11/2021
- Field of study
OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease
Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries
- Author
- A Yacoub Mina
- A. Adam Mohammed
- A. Nassar Mahmoud
- A.Nemer Ayoob
- Aahlin Eirik Kjus
- Ab Rahim Mohd Fadliyazid
- Abad Gurumeta Alfredo
- Abad-Motos Ane
- Abang Jamari Dyg Zahratul Hamrak
- Abantanga Francis
- Abarca Sol
- Abazid Eias
- Abbas Abbas
- Abbas Khalid
- Abbas Mohammad Monir
- Abbasy Jibran
- Abbosh Ali
- Abd Karim Muhammad Fairuz Shah
- Abd Wahab Haidar Hadri
- Abd Barook
- Abdalei Abdulwahab
- Abdalla Ahmed Elkamel Ahmed
- Abdallah Aya
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- Clements Joshua Michael
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- Cockbain Andrew J
- Cocorullo Gianfranco
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- Curletti Gianluca
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- De Azevedo Bernardo
- De Castro Parga Gonzalo
- De Giovanni Jasmine
- de Jonge Joske
- de la Torre Javier
- De Luca Emilia
- De Marco Paolino
- de Muijnck Cansu
- de Oliveira Daniela
- De Rosa Michele
- De Santiago Alvarez Irene
- De Silva April
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- Deans Chris
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- Deepika Garg
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- Diéguez Beatriz
- Doe Matthew
- Dogruoz Alper
- Doherty Ronan J
- Dollie Qaasim
- Dominguez Genieve
- Dominguez Joaquina
- Domini Edgar
- Dossou Francis
- Dousset Bertrand
- Draganic Brian
- Drake Thomas M
- Drane Andrew
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- Dudi-Venkata Nagendra Naidu
- Duggan William
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- Duller Alexander
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- El Nakeeb Ayman
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- Eldoseuky mohammed Amany
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- Elewaily Mohamed Ibrahim Elsayed
- Elfaituri Taha
- Elfallal Ahmed
- Elfanty Mahmoud
- ElFayoumy Ahmed Moustafa
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- Elshawy Mohamed Elemam
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- Elzanfaly Ali Abdelazez
- Emara Eman
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- Enumah Zachary
- Eraslan Huseyin
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- Eskander John
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- Esper Asil
- Espin-Basany Eloy
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- Espinosa-Bravo Martin
- Esposito Giovanni
- Essam Ibrahim El Desouki Muhammad Ahmed Muhammad
- Essam Eman
- Estalagem InĂȘs
- Estevez Tesouro José
- Eswaye Haitem
- Etchill Eric
- Etonyeaku Amarachukwu
- Eusebio Zegarra Ivan Edward
- Ezzat Helmy
- Fadel Ahmed
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- Fahmawee Toqa
- Fairfield Cameron J
- Falato Armando
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- Falco NicolĂČ
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- Fernandez-Diaz Maria Jose
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- FernĂĄndez MartĂnez Daniel
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- Finlay Ben
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- Fitzgerald J Edward
- Flamey Nicolas
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- Forero-Torres Alexander
- Fortuna Martins SĂłnia
- Foschi Diego
- Foster Deshka S
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- Fragoso Marta
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- Franczak Paula
- Franklin Oskar
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- Garfinkle Richard
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- Gezer Zeynep Ipek
- Ghalleb Montassar
- Ghaly Khaled
- Ghellai Ali M.
- Ghonaim Mennatullah
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- Wondoh Paul M.
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- Yabut Kenneth
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- Yaghi Nadine
- Yaghi Yasmine
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- Yakushkina Al'ona
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- Yang P Zichu
- Yanikoglu Erkan
- Yanni Fady
- Yates Charlotte
- Ye Geoffrey
- Yeen Chin Leow
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- Yenli Edwin
- Yeo Jeremy
- Yeoh Andrea
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- Yildirim Reyyan
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- Yong Shun Qi
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- Yorke Joseph
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- You Lucia
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- Yusuf Baasil
- YĂŒksel Osman
- Zabiyaka Mikhail
- Zachariah Sanoop Koshy
- Zafar Syed Nabeel
- Zaffaroni Gloria
- Zahra Baryab
- Zahran Diaaaldin
- Zakaria Andee Dzulkarnaen
- Zakaria Mai
- Zakaria Omar
- Zakaria Zaidi
- Zambrana Campos Vanesa
- Zammit Matthew
- Zanini Nicola
- Zara Vlu Jean
- Zara Vlu Jean
- Zarti Heba
- Zarzycki Piotr
- Zattoni Davide
- Zavala Gabriela
- Zawahrah Hassan
- Zeiton Asaid
- Zeko Amanda
- Zeng Zhi
- Zeromskas Paulius
- Zhang Geoffrey
- Zhivkov Evgeni
- Zid Esraa
- Zidan Ahmed Mohy
- Zielasek Christian
- Zilinskas Justas
- Zimmermann Bernd
- Ziprin Paul
- Zizzo Maurizio
- Zografos George
- Zoikas Athanasios
- Zorrilla Matilla Laura Patricia
- Zoulamoglou Menelaos
- Zreeg Dafer
- Zub-Pokrowiecka Anna
- Zubiaurre Vanessa
- Zuhdy Mohammed
- Zuikyte Diana
- Zuloaga Fernandez del Valle Carlos Jose
- Zulu Stanley
- Ăngelo Miguel
- ĂlgĂ„ Andreas
- Ăolak Elif
- Ămarik Toomas
- Ć atkauskas Mindaugas
- Ć kimelyte Monika
- Ć lenfuktas Vygintas
- Ć uman Oliver
- ĆœateckĂœ Jan
- Ćœumbakys Ćœygimantas
- Ćœupan Domagoj
- Publication venue
- 'Elsevier BV'
- Publication date
- 30/01/2021
- Field of study
© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70â8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39â8·80) and upper-middle-income countries (2·06, 1·11â3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26â11·59) and upper-middle-income countries (3·89, 2·08â7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit
Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study
- Author
- A Yacoub Mina
- A. Adam Mohammed
- A. Nassar Mahmoud
- A.Nemer Ayoob
- Aahlin Eirik Kjus
- Ab Rahim Mohd Fadliyazid
- Abad Gurumeta Alfredo
- Abad-Motos Ane
- Abang Jamari Dyg Zahratul Hamrak
- Abantanga Francis
- Abarca Sol
- Abazid Eias
- Abbas Abbas
- Abbas Khalid
- Abbas Mohammad Monir
- Abbasy Jibran
- Abbosh Ali
- Abd Karim Muhammad Fairuz Shah
- Abd Wahab Haidar Hadri
- Abd Barook
- Abdalei Abdulwahab
- Abdalla Ahmed Elkamel Ahmed
- Abdallah Aya
- AbdAllah Mostafa Salim Mohamed
- Abdel Malik Abu Baker
- Abdelhady Mousa Heba
- Abdelhady Samar
- Abdelhakim Ahmed
- Abdelkader Muhammad
- Abdelkawy Shaza
- Abdelkhalek Mohamed
- Abdellatif Esraa
- Abdelmaksoud Tawakel Noura
- Abdelmohsen Naglaa
- Abdelmotaleb Ibrahem
- Abdelrazek Aly
- Abdelsalam Israa
- Abdelshakour Mahmoud
- Abdelwahed Ahmed Mohamed
- Abdou Abdulrahman Osama
- Abdou Alrawy
- Abdou Hossam
- Abdul Aziz Mohamed Rezal
- Abdul Aziz Nora
- Abdulgawad Almogy Mariam
- Abdulla Mazin A.
- Abdullah Muhammad Tariq
- Abdullahi Lawal
- Abdullayev Seymur
- Abed Saeed
- AbellĂł David
- Abiola Olajide
- Abo mahadi Asmaa'
- Abo-khammash Areej
- Abou Chaar Mohamad K.
- Abou El.soud Moustafa Ramadan
- Abouelsoad Nervana
- Abraham Joyner
- Abreu da Silva Alberto
- Abu Ahammala Ayman B.
- Abu Al Amrain Mahmoud
- Abu Al-saleem Hasan
- Abu Alamrain Abdulwhhab
- Abu Alqumboz Amjad
- Abu Ataya Ahmed
- Abu hallalah Muad fathi khalleefah
- Abu Jamie Najlaa
- Abu Jayyab Israa
- Abu shua'ib Rana
- Abu Zainah Baraa
- Abu-Nimeh Samar
- Abu-Rous Mohammed R.
- Abu-srour Abrar
- Abuelhatal Hasan
- Abuelqomboz Ayham
- Abuhilal Baseel
- Abuhlaiga Ma'aly
- Abujamra Saleh
- Abukhalaf Sadi A.
- Abusalem Lana
- AbuSirrees Mahmoud
- Acevedo Veronica
- Acharya Rajgopal
- Achkasov Sergey
- Acosta Eric
- Adamo Karin
- Adamou Harissou
- Adams Jamie
- Adams Lawrence
- Adawi Samer
- Adebanjo Ademola
- Adel Marina
- Adel Sawsan
- Ademuyiwa Adesoji
- Ademuyiwa Adesoji O
- Adenuga Adedire
- Aderounmu Adewale
- Adesanya Opeoluwa
- Adesina Alaba
- Adesunkanmi Abdul-Rashid
- Adeyeye Ademola
- Adidharma Peter
- Adisa Adewale
- Adisa Adewale O
- Adnan Nour
- Afifi Amr Abdelghani
- Afifi Eman
- Afolayan Michael Olatunji
- Afzal Asma
- Agarwal Arnav
- Agarwal Raksheeth
- Agbakwuru Augustine
- Agbeko Anita Eseenam
- Aguilar Martinez Maria Del Mar
- Aguilera Maria Lorena
- Aguilera-Arevalo Maria-Lorena
- Ahlqvist Sandra
- Ahmad Izzuddin Ahmad Imran
- Ahmad Kasim
- Ahmad Sarwat
- Ahmed Ahmedgaber
- Ahmed Hazem Abdelkarem
- Ahmed Mariam
- Ahmed Nabila
- Ahmed Zahra
- Ainoa Eppu
- Aithie Joanna M S
- Ajani Costanza
- Ajao Akinlabi
- Ajiboye Anthony
- Ajmera Ankit
- Akande Oluwatosin
- Akaydin Elif
- Akbaba Ata Cem
- Akbar Sana Amir
- Akeel Nouf
- Akeem Aderogba Adeleke
- Akin Alp
- Akinkuolie Akinbolaji
- Akisheva Aygulya
- Akitikori Mabel Temisanren
- Akrida Ioanna
- Aktas Melik Kagan
- Al basos Iyad
- Al Farsi Maryam
- Al Nassrallah Majdi
- Al Sagheir Eman
- Al Saqqa Sara
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- Wogensen Fredrik
- Wondoh Paul M.
- Wong Florence
- Wong Hsu Ven
- Wong Jane J
- Wong Jeremy
- Wong Lai Fen
- Wong Michael Pak-Kai
- Wong Sui-Weng
- Wong Tsz Lun Ernest
- Wood Lauren
- Woon-Shoo-Tong Xiao-Ming Sarah
- Wren Sherry
- Wuraola Funmilola
- Xanthopoulou Georgia
- Yabut Kenneth
- Yacoub Aseel
- Yaghi Nadine
- Yaghi Yasmine
- Yahia Mohamed Ali Mohamed
- Yakushkina Al'ona
- Yalçinkaya Ali
- Yang P Zichu
- YanikoÄlu Erkan
- Yanni Fady
- Yates Charlotte
- Ye Geoffrey
- Yeen Chin Leow
- Yemez KĂŒrĆat
- YenidĂŒnya NilĂŒfer
- Yenli Edwin
- Yeo Jeremy
- Yeoh Andrea
- Yepez Raul
- YeĆilsancak Merve
- Yildirim Reyyan
- Yildiz Alp
- Yilmaz Duygu
- Yip Ching Wan
- Ylatoma DĂaz Edgar Alcides
- Yong Shun Qi
- Yoong Andrel
- Yorke Joseph
- Yotsov Tsanko
- You Lucia
- Younes Eman
- Younes Maha
- Yousry Basant
- Yozgatli Tahir Koray
- Yu Kristin
- Yue Sum Yu Pansy
- Yunes Asmaa
- Yusuf Baasil
- YĂŒksel Osman
- Zabiyaka Mikhail
- Zachariah Sanoop Koshy
- Zafar Syed Nabeel
- Zaffaroni Gloria
- Zahra Baryab
- Zahran Diaaaldin
- Zakaria Andee Dzulkarnaen
- Zakaria Mai
- Zakaria Omar
- Zakaria Zaidi
- Zambrana Campos Vanesa
- Zammit Matthew
- Zanini Nicola
- Zara Vlu Jean
- Zarti Heba
- Zarzycki Piotr
- Zattoni Davide
- Zavala Gabriela
- Zawahrah Hassan
- Zeiton Asaid
- Zeko Amanda
- Zeng Zhi
- Zeromskas Paulius
- Zhang Geoffrey
- Zhivkov Evgeni
- Zid Esraa
- Zidan Ahmed Mohy
- Zielasek Christian
- Zilinskas Justas
- Zimmermann Bernd
- Ziprin Paul
- Zizzo Maurizio
- Zografos George
- Zoikas Athanasios
- Zorrilla Matilla Laura Patricia
- Zoulamoglou Menelaos
- Zreeg Dafer
- Zub-Pokrowiecka Anna
- Zubiaurre Vanessa
- Zuhdy Mohammed
- Zuikyte Diana
- Zuloaga Fernandez del Valle Carlos Jose
- Zulu Stanley
- Ăngelo Miguel
- ĂlgĂ„ Andreas
- Ăolak Elif
- Ămarik Toomas
- ÄepulienĂ© Daiva
- Ćahin Can
- Ć atkauskas Mindaugas
- Ć kimelytĂš Monika
- Ć lenfuktas Vygintas
- Ć uman Oliver
- ĆœateckĂœ Jan
- Ćœumbakys Ćœygimantas
- Ćœupan Domagoj
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/07/2022
- Field of study
© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 studyâa multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58â5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23â0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research
Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies
- Author
- Aage Christiansen
- Aaradhana Adhikari
- Aaron Venti
- Aayesha Qadeer
- Abdellatif Benslama
- Abigail Beane
- Abu Hena Mostafa Kamal
- Abul Faiz
- Adam B Schlichting
- Adam Bell Bell
- Adenilton M R Ampinelli
- Aditya Uppalapati
- Adrian Donnelly
- Adriana M Fernandez
- Adrien Robine
- Aftab Akhtar
- Agreta Gecaj-Gashi
- Ahmed Farooq
- Ahmed S Al Jabbary
- Ahmet Dilek
- Ahmet Sukru Denker
- Ai Y Hang
- Aiman Tulaimat
- Akihiro Takaba
- Akinori Uchiyama
- Akira Hirata
- Akm Shamsul Alam
- Akut Aytulun
- Alain Combes
- Alain M Dive
- Alain Mercat
- Alain U Alisasis
- Alan Zazu
- Alastair Rose
- Alberto Deicas
- Alec A Tallet Alfonso
- Alejandro A Saez
- Alejandro Ebeid
- Alejandro G Castro
- Alejandro R Bruhn
- Alek Kumar
- Alessandro Bacuzzi
- Alessandro Protti
- Alessia Mattei
- Alex Mcleod
- Alex Morton
- Alexandra Ceniceros-Barros
- Alexandra J Williams
- Alexandra Marcu
- Alexandra Siqueira Colombo
- Alexandre Biasi Cavalcanti
- Alexandre Biasi Cavalcanti
- Alexandre Chan
- Alexandre Demoule
- Alexandre Guilherme Ribeiro de Carvalho
- Alexandre Molin
- Alexandre Molin
- Alexey I Gritsan
- Alfons Arizmendi
- Aline Ascoli
- Alison Ghosh
- Alistair Nichol
- Alistair Roy Roy
- Alma Cani
- Alvaro Ramirez-Gutierrez
- Amadeu Martinez
- Amanda Cowton
- Amanda Krstevski
- Amanda Maria R R de Oliveira
- Amanda Skinner
- Amanda Whileman
- Amine Ali Zeggwagh
- Amine Ali Zeggwagh
- Amy McInerney
- Ana Carolina P AntĂŽnio
- Ana Carolina Peçanha
- Ana G França
- Ana M Araujo
- Ana M Pellicer
- Anais Briquet
- Anand Dongre
- Anatole Harrois
- Anders Aneman
- Anders Larsson
- Andre Japiassu
- Andre Luiz Baptiston Nunes
- Andre Luiz Baptiston Nunes
- Andre Vercueil
- Andrea Coppadoro
- Andrea Cortegiani
- Andrea Cortegiani
- Andrea Lombardo
- Andrea N Cracchiolo
- Andrea Tinnirello
- Andreas Barratt-Due
- Andreas W Reske
- Andrej Sribar
- Andrew Bentley
- Andrew Corner
- Andrew Ferguson
- Andrew J Burtenshaw
- Andrey A Gazenkampf
- André Peretti Torelly
- Angela Delsing
- Angela Pinder
- Aniko D Frigyik
- Anil Hormis
- Anil P Hormis
- Anitha Shenoy
- Anna Hunt
- Anna Oscarsson Tibblin
- Anna Rossi
- Anna T Dowling
- Anna Walker
- Anna-Karin Morin
- Anne Adolfsson
- Anne B Guttormsen
- Annop Piriyapatsom
- Antero do Vale Fernandes
- Antoine Pronovost
- Antonino Giarratano
- Antonio Artigas
- Antonio Braschi
- Antonio Carlos Nogueira
- Antonio G Jimenez
- Antonio Jorge Pereira
- Antonio L Ruiz-Aguilar
- Antonio P Nassar Jr
- Antonio Paulo Nassar Junior
- AntĂłnio M Alvarez
- AntĂłnio M Messias
- Aogan C O'Muircheartaigh
- Areef Ahsan
- Areej Javeed
- Ariel Chena
- Arnaud Follin
- Arshad Taqi
- Arvind K Baronia
- Ary Serpa Neto
- Ashley Schomer
- Ashok S Raj
- Asisclo J Villagomez
- Asisclo Villagomez
- Asma Ben Souissi
- Asma Navasakulpong
- Asoka Gunaratne
- Atta Ur Rehman
- Aurelia M Martinho
- Aylin Seven
- Bao H Zhu
- Barbara Brunettini
- Barbara do Cs Martins
- Barrett T Kitch
- Barry Dixon
- Barry Kennedy
- Basak Ceyda Meco
- Batoul Khoundabi
- Beatriz C Tan
- Behzad Nadjm
- Ben Creagh-Brown
- Bernard Goubaux
- Bernhard Holzgraefe
- Bhagyesh Shah
- Bhuvana Krishna
- Bimal Kudavidanage
- Bin Li
- Bingyu Qin
- Bojan Jovanovic
- Boris G Villamagua
- Brenno Cardoso Gomes
- Brigit L Roberts
- Brit Ă SjĂžbĂž
- Bruno Franco Mazza
- Bruno Gelée
- Bruno S Oliveira
- Candelaria De Haro
- Carlo A Volta
- Carlo Alberto Volta
- Carlos A Pellegrini
- Carlos Eduardo Barboza
- Carlos Munhoz
- Carlos S Pereira
- Carly Brown
- Carmen Scott
- Carolina Quintana Grijalba
- Carolina S Insaurralde
- Carolina Serra
- Caroline Berghe
- Caroline C MacFie
- Caroline Wreybrown
- Cassia Righy
- Cassiano Teixeira
- Catalina Forteza
- Catherine Plowright
- Cecilia Carbayo-Gorriz
- Cecilia Hermosa
- Ceri E Battle
- Cesar A Cortez
- Cesar Milstein
- Cesar P Pere
- Chamila Pilimatalawwe
- Charlene Bigot
- Charlene Le Moal
- Charlotte Downes
- Chathurani Sigera
- Chern Min Voon
- Cheryl Padilla-Harris
- Chinni Krishna Kasi
- Chloe Hughes
- Christian C Rylander
- Christian Dellera
- Christian Frey
- Christian M Ramirez-Alfaro
- Christian Schlegel
- Christina Whitehead
- Christine Boyd
- Christine Brown
- Christine Ryan
- Christoph Muench
- Christopher J Scott
- Christopher Nutt
- Christopher Smalley
- Christopher Tainter
- Chunting Wang
- Claine Judy
- Clair Harris
- Claire Kaloo
- Claire Matthews
- Claire Miller
- Claire Pegg
- Claire Reynolds
- Clare Bullock
- Clare Mellis
- Clare Mellis
- Claude Guérin
- Claudia A Ortiz
- Claudia R Estrella
- Claudio H Gonçalves
- Claudio Piras
- Claudio Piras
- Claudio Piras
- Colette Seasman
- Colette Seasman
- Colin K Grissom
- Colin Mcarthur
- Colin S Black
- Cora Lavigne Moreira
- Corcoles G Virgilio
- Corinne Leemann-Refondini
- Cristiane Ritter
- Cristiane Tomasi Damiani
- Cristina M Cox
- Cristina Prata Amendola
- Cristina Santos
- Cristina Santos
- CĂ©dric Daubin
- Daisuke Niimi
- Dale J Yeatts
- Dalton de Souza Barros
- Damien Roux
- Dan E Corneci
- Dan Hadfield
- Dana R Tomescu
- Daniel AragĂŁo
- Daniel Beraldo
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- Tai Pham
- Takeshi Ueda
- Tamas Szakmany
- Tananchai Petnak
- Tanja A Treschan
- Tanveer Hussain
- Tao Yu
- Taohidul Majid Taohid
- Tarek Dendane
- Tarikul Hamid
- Tasmin Patel
- Tatjana Simurina
- Teresa Honrubia
- Terri-Ann Sewell
- Tharwat M Aisa
- Theonymfi G Papavasilopoulou
- Thiago Lisboa
- Thomas Baltus
- Thomas C Blakeman
- Thomas Collyer
- Thomas Kander
- Thomas Staudinger
- Thuy Duong Bich
- Théia Forny Wanderley CastellÔes
- Tiago Macruz
- Tie H Qin
- Tim Wenham
- Tom Hatton
- Tomas P Roser
- Tomaz Mesar
- Tomaz Mesar
- Tommaso Fossali
- Tomoaki Hashida
- Tomofumi Harasawa
- Tomoyuki Nakamura
- Toni E Mckenna
- Toshikazu Abe
- Tracey Evans
- Trevor W Oetting
- Troy S B Rowne
- TĂ i Pham
- Udomsak Silachamroon
- Ugur Goktas
- Ulysses V A Silva
- Una Poultney
- Unase Buyukkocak
- Upeka Samaranayake
- Ushio Higashijima
- Valeria I Cerrato
- Valerie M Banner-Goodspeed
- Vallish K Bhardwaj
- Vallverdu P Imma
- Valéria Maria Campos Rezende
- Vanessa Linnett
- Vanessa M Sales
- Vanessa Oliveira
- Vania A Brito
- Varsha Kadaba
- Vasilis Ourailogloy
- Venika Manoharan
- Venkatapura J Ramesh
- Veronica Villar
- Vesna Bumbasierevic
- Vesna Bumbasirevic
- Vicente CĂ©s de Souza Dantas
- Vijayanand Palaniswamy
- Vincenzo Pota
- Vincenzo Russotto
- Vincenzo Schiavone
- Viratch Tangsujaritvijit
- Virginie Lemiale
- Visanthi Pinto
- Vivek Kakar
- Vladimir Cerny
- Vlasta Klaric
- Wahid Altaf
- Wajdi Maazouzi
- Wei H Zhu
- Wei Wang
- Weihua Lu
- Wenkui Yu
- Wenwen Li
- Werner Schmid
- William Stigler
- Xavier Wittebole
- Xian Y Zhao
- Xiao B Huang
- Xiao L Li
- Xiaoming Luo
- Xing Y Zhang
- Xinyu Li
- Y A Hasitha Dilhani
- Ya Q Wu
- Yaasen Arabi
- Yan Gao
- Yaseen M Arabi
- Yasuaki Ogino
- Yavuz Orak
- Yen Lam Minh
- Yi Han
- Yimin Li
- Yonghao Xu
- Yoshihiro Yamaji
- Yoshinobu Kameyama
- Youssef Haddad
- Youzhong An
- Yozo Kashiwa
- Yu D Di
- Yuan N Gao
- Yuan Y Li
- Yuanhua Lu
- Yves D Jarquin-Badiola
- Zerrin DemirtĂŒrk
- Zhe Zhai
- Zheng L Ye
- Zhenyang He
- Zhou Li-Xin
- Ălvaro RĂ©a-Neto
- Ăngela Algaba
- Ăngela GonzĂĄlez-Salamanca
- Ăiler Zincircioglu
- Ărica Aranha Suzumura
- Ănio Rego
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2021
- Field of study
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 define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality.
Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001).
Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status