82 research outputs found
Swine farm wastewater and mineral fertilization in corn cultivation
- Author
- Cabral J. R.
- Condé M. S.
- Danielle M. Rosa
- Doblinski A. F.
- Ferreira M. M. M.
- Girotto E.
- Kappes C.
- Kessler N. C. H.
- Kessler N. C. H.
- Kessler N. C. H.
- Lourenzi C. R.
- Lucas S. D. M.
- Maggi C. F.
- Malavolta. E.
- Marcus M. Correa
- Mellis E. V.
- Meneghetti A. M.
- Munns R.
- Pâmela A. M. Pereira
- Queiroz J. E.
- Raij B. van
- Ralpho R. dos Reis
- Regitano J. B.
- Salvador J. T.
- Sampaio S. C.
- Santos D. R. dos
- Silvio C. Sampaio
- Smanhotto A.
- Sodré F. F.
- Tessaro D.
- Publication venue
- 'FapUNIFESP (SciELO)'
- Publication date
- Field of study
Sorção de potássio em amostras de solo submetidas à aplicação de vinhaça
- Author
- Alleoni L. R. F.
- Bhat S. N.
- Brito F. L.
- Bueno P. C.
- Canellas L. P.
- Casagrande J. C.
- Chang T. W.
- Cruz J. I.
- Dias N. M. P.
- Du Y. J.
- Eliana B. N. R. Lima
- Fernanda S. C. Soares
- Gonçalves C. R.
- Gonçalves D. B.
- Goudar M. S.
- Lelis Neto J. A.
- Lorena M. Nicochelli
- Lyra M. R. C. C.
- Mellis E. V.
- Mellis E. V.
- Queiroz P. I. B.
- Rejane Nascentes
- Salomon K. R
- Santos L. V.
- Sartaj M.
- Shenbagavalli S.
- Silva M. A. S.
- Silveira M. L. A.
- Soares M. R.
- Vega F. A.
- Yamamura A. P. G.
- Publication venue
- 'FapUNIFESP (SciELO)'
- Publication date
- Field of study
Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.
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- Ab Majid MA
- Ab Rahman AS
- Ab Rahman R
- Abayasinghe C
- Abbott T
- Abdullah NH
- Abdur-Rahman L
- Abeloos J
- Abernethy C
- Abidin UN
- Abrunhosa A
- Absar M
- Adam S
- Adams D
- Adams G
- Adamson M
- Adekola O
- Adelaja Y
- Ademola A
- Adenekan A
- Adenike O
- Adeolu AA
- Adetoye A
- Adewale B
- Adigun T
- Adolfsson A
- Aflori L
- Africander C
- Afshari A
- Agarwal V
- Agodirin O
- Aguero Vera M
- Aguzzoli C
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- Ai Y
- Aignatoaie M
- Aimoniotou-Georgiou E
- Akanmu O
- Akerman N
- Akinwale M
- Akring I
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- Al Anizi M
- Al hussaini S
- Al-Soudaine Y
- Aladin H
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- Alaman Laguarda G
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- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2016
- Field of study
BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700
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
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- 'Elsevier BV'
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- 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\ub74% vs 44\ub72%; absolute difference \u20131\ub769 [\u20139\ub758 to 6\ub711] p=0\ub767; 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\u20138] vs 6 [5\u20138] cm H2O; p=0\ub70011). ICU mortality was higher in MICs than in HICs (30\ub75% vs 19\ub79%; p=0\ub70004; adjusted effect 16\ub741% [95% CI 9\ub752\u201323\ub752]; p<0\ub70001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0\ub780 [95% CI 0\ub775\u20130\ub786]; p<0\ub70001). 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. Funding: No funding
Relationship between soil properties and potentially toxic element content based on the dataset of the Soil Information and Monitoring System in Hungary
- Author
- Adhami E.
- Adriano D.C.
- Alloway B.J.
- András Makó
- Bergkvist P.
- Bradl H.B.
- Camobreco V.J.
- Csathó P.
- Elkhatib E.A.
- Field A.
- Fodor L.
- Ford R.G.
- Fügedi U.
- Goldberg S.
- Hlavay J.
- Judit Üveges
- Juhász I.
- Kovács E.
- Kuti L.
- Kádár I.
- McLean E.O.
- Mellis E.V.
- Navarro M.C.
- Nelson R.E.
- Pigna M.
- Pinheiro J.P.
- Ramachandran V.
- Sajtos L.
- Shuman L.M.
- Stefanovits P.
- Szilveszter Csorba
- Tyurin I.V.
- Voegelin A.
- Várallyay Gy.
- Xu R.K.
- Publication venue
- 'Akademiai Kiado Zrt.'
- Publication date
- Field of study
A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)
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- CAPCRI Study
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- Cariou A
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- Carpio D
- Carratalá A
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- Carrero-Gómez F
- Carreño ER
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- Carvalho JP
- Carvalho KV
- Casals XN
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- Cassina T
- Castañeda DP
- Castellana D
- Castellanos A
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- Castillo-Lorente E
- Castillo-Lorente E
- Catalan M
- Catalán RM
- Catena E
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- Cauwenberghs H
- Cavalcanti D
- Cavalheiro AM
- Cavalier E
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- Champigneulle B
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- Charron C
- Chatelon J
- Chaudhari HK
- Chaussard M
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- Chelly J
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- Cheng CC
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- Chernyshuk S
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- Chhor V
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- Chiappa C
- Chiou KR
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- Chiu LC
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- Chiurazzi C
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- Cho Y
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- Chok L
- Cholkraisuwat J
- Cholley B
- Chondropoulos S
- Chou W
- Chouris I
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- Chumaev A
- Chung CR
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- Chytas A
- Cinel I
- Cinnella G
- Citerio G
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- Clemente EA
- Clermont G
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- Colaprico A
- Colino L
- Collange O
- Colombo A
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- Colson P
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- Concha P
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- Constan A
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- Cook DJ
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- Cordeiro CP
- Cordero M
- Cordolcini V
- Cordovilla-Guardia S
- Cordón J
- Corona A
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- Cui N
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- Curinga M
- Curtis A
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- Cutuli SL
- Câmara M
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- da Silva VZ
- Daga-Ruiz D
- Dalhuisen A
- Dalorzo M
- Damas P
- Dambrosio M
- Damås JK
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- David H
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- Day A
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- De Brito-Ashurst I
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- De Freitas FF
- De Gasperi A
- de Hoyos EA
- De la Calle-Pedrosa N
- de la Fuente MV
- De La Fuente-Martos C
- De La Fuente-Martos C
- De La Rica AS
- De la Torre MA
- De Maglie M
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- De Pascale G
- De Rosa S
- De Sanctis F
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- De Sousa I
- de Vera AP
- de Wilde W
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- Deblier I
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- Del Olmo R
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- Di Gravio V
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- Dimopoulou IK
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- E YY
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- El Sayed E
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- Elbers PW
- Elgendy M
- Eliet J
- Emmanuel J
- Emmerich M
- Encina B
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- Endacott R
- Engelberts D
- ENVIN-HELICS Study Group
- Erb J
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- Esteban A
- Estella A
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- Ferez MA
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- Fernandez R
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- Fernández L
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- Fernández-Ortega JF
- Ferraz AB
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- Ferri F
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- Fiks T
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- Filho CA
- Filho CA
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- FINNRESUSCI Study Group
- Fischer G
- Fleischmann E
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- Frithiof R
- Fritz C
- FROG ICU Investigators
- Fromentin M
- Frontera PR
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- Gayat E
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- Genève C
- Georgopoulos D
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- GETGAG Working Group
- GETGAG/SEMICYUC
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- Hernández A
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- Herpain A
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- Ignacio ML
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- Ilyina V
- Imanaka H
- Inaloo S
- Ince C
- Iotti GA
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- IPREA Study Group
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- Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study group
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- Jayasinghe S
- Jean-Baptiste S
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- Jensen JU
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- Jovaisa T
- JSEPTIC (Japanese Society of Education for Physicians and Trainees in Intensive Care) Clinical Trial Group
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- Juanas CA
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- Juliarena A
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- Kolnikova I
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- Kumari BK
- Kumbamu A
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- Kurmukov IA
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- Kwon WY
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- Lin KC
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- Lobo-Civico A
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- Lombardo MD
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- Loudet CI
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- Martín-Loeches I
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- Martínez MV
- Martínez NA
- Martínez-Carmona JF
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- Mejías CR
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- Mendes A
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- Menendez R
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- Merino-Vega D
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- Welters I
- Wetz A
- Weyer CM
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- Wiesner O
- Wijayatilake DS
- Wildenberg L
- Wilks M
- Wilson ME
- WIND study group
- WIND study group
- WIND study group
- Winder-Rhodes S
- Witter T
- Wolf M
- Wolff M
- Wong Y
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- Xie Z
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- Yamaguchi O
- Yamaguchi Y
- Yamaguchi Y
- Yamamoto H
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- Yamashita K
- Yamazaki A
- Yan WW
- Yan WW
- Yang JH
- Yang JS
- Yang YL
- Yasuda H
- Yatabe T
- Yebenes JC
- Yeh YC
- Yemets H
- Yergaliyeva A
- Yılmaz G
- Yilmazer F
- Yodice P
- Yokoyama M
- Yonis H
- Yonis H
- Yonis H
- Yoon SZ
- Yoruk F
- Yoshida K
- Yoshida T
- Yoshida T
- Yoshida T
- Yoshida T
- Yoshihiro S
- Yoshitake E
- You KM
- Youn AM
- Young A
- Yu KM
- Yumoto T
- Yuzawa J
- Yuzawa J
- Zabaletta WJ
- Zabini D
- Zahorec M
- Zaien I
- Zakynthinos S
- Zanello M
- Zani D
- Zarantonello F
- Zayas B
- Zepeda EM
- Zeroual N
- Zerva L
- Zhang J
- Zhou JC
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- Zhou JX
- Zhovnir V
- Zibandah N
- Zijlstra F
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- Zullino V
- Zwaag J
- Zýková I
- Álvarez JT
- Álvarez-Lerma F
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2016
- Field of study
Meeting abstrac
Spontaneous Breathing in Early Acute Respiratory Distress Syndrome: Insights From the Large Observational Study to UNderstand the Global Impact of Severe Acute Respiratory FailurE Study
- Author
- Abad RD
- Abe T
- Abroug F
- Adams JC
- Adamsson RO
- Adolfsson A
- Aguilar RZ
- Aguirre JS
- Aguirre-Bermeo H
- Aisa TM
- Aisiku I
- Ajetunmobi OO
- Aker M
- Akyol OO
- Al Dorzi HM
- Al Jabbary AS
- Albaiceta GM
- Albarrak MM
- Albiero D
- Alda RS
- Alejandro RV
- Alexander P
- Algaba Á
- Aliaga FA
- Alisasis AU
- Allan RM
- Allue RM
- Almekhlaf G
- Alonso JG
- Altaf W
- Alvarez AM
- Alvarez J
- Amin P
- Amir F
- Amor M
- An Y
- Andersen FH
- Andoh K
- Andruszkiewicz P
- Aneman A
- Antonelli MM
- Antônio ACP
- Aoki N
- Appelberg H
- Arabi Y
- Arabi YM
- Araujo AM
- Arizmendi A
- Arnal JM
- Artiga MJD
- Artigas A
- Ascoli A
- Au SM
- Avila LE
- Azad R
- Azevedo LC
- Baboi L
- Badie JC
- Bailey IM
- Bailey MB
- Bajwa E
- Balkhi H
- Baltus T
- Banner-Goodspeed VM
- Barberet G
- Baron RM
- Baronia AK
- Barratt-Due A
- Barros FM
- Barros NC
- Batra H
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- Publication venue
- 'Ovid Technologies (Wolters Kluwer Health)'
- Publication date
- 01/01/2019
- Field of study
OBJECTIVES: To describe the characteristics and outcomes of patients with acute respiratory distress syndrome with or without spontaneous breathing and to investigate whether the effects of spontaneous breathing on outcome depend on acute respiratory distress syndrome severity. DESIGN: Planned secondary analysis of a prospective, observational, multicentre cohort study. SETTING: International sample of 459 ICUs from 50 countries. PATIENTS: Patients with acute respiratory distress syndrome and at least 2 days of invasive mechanical ventilation and available data for the mode of mechanical ventilation and respiratory rate for the 2 first days. INTERVENTIONS: Analysis of patients with and without spontaneous breathing, defined by the mode of mechanical ventilation and by actual respiratory rate compared with set respiratory rate during the first 48 hours of mechanical ventilation. MEASUREMENTS AND MAIN RESULTS: Spontaneous breathing was present in 67% of patients with mild acute respiratory distress syndrome, 58% of patients with moderate acute respiratory distress syndrome, and 46% of patients with severe acute respiratory distress syndrome. Patients with spontaneous breathing were older and had lower acute respiratory distress syndrome severity, Sequential Organ Failure Assessment scores, ICU and hospital mortality, and were less likely to be diagnosed with acute respiratory distress syndrome by clinicians. In adjusted analysis, spontaneous breathing during the first 2 days was not associated with an effect on ICU or hospital mortality (33% vs 37%; odds ratio, 1.18 [0.92-1.51]; p = 0.19 and 37% vs 41%; odds ratio, 1.18 [0.93-1.50]; p = 0.196, respectively ). Spontaneous breathing was associated with increased ventilator-free days (13 [0-22] vs 8 [0-20]; p = 0.014) and shorter duration of ICU stay (11 [6-20] vs 12 [7-22]; p = 0.04). CONCLUSIONS: Spontaneous breathing is common in patients with acute respiratory distress syndrome during the first 48 hours of mechanical ventilation. Spontaneous breathing is not associated with worse outcomes and may hasten liberation from the ventilator and from ICU. Although these results support the use of spontaneous breathing in patients with acute respiratory distress syndrome independent of acute respiratory distress syndrome severity, the use of controlled ventilation indicates a bias toward use in patients with higher disease severity. In addition, because the lack of reliable data on inspiratory effort in our study, prospective studies incorporating the magnitude of inspiratory effort and adjusting for all potential severity confounders are required
Identifying associations between diabetes and acute respiratory distress syndrome in patients with acute hypoxemic respiratory failure: an analysis of the LUNG SAFE database
- Author
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- Albaiceta Gm
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- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2018
- Field of study
Background: Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The objective of this study was to evaluate associations between pre-existing diabetes mellitus and ARDS in critically ill patients with acute hypoxemic respiratory failure (AHRF). Methods: An ancillary analysis of a global, multi-centre prospective observational study (LUNG SAFE) was undertaken. LUNG SAFE evaluated all patients admitted to an intensive care unit (ICU) over a 4-week period, that required mechanical ventilation and met AHRF criteria. Patients who had their AHRF fully explained by cardiac failure were excluded. Important clinical characteristics were included in a stepwise selection approach (forward and backward selection combined with a significance level of 0.05) to identify a set of independent variables associated with having ARDS at any time, developing ARDS (defined as ARDS occurring after day 2 from meeting AHRF criteria) and with hospital mortality. Furthermore, propensity score analysis was undertaken to account for the differences in baseline characteristics between patients with and without diabetes mellitus, and the association between diabetes mellitus and outcomes of interest was assessed on matched samples. Results: Of the 4107 patients with AHRF included in this study, 3022 (73.6%) patients fulfilled ARDS criteria at admission or developed ARDS during their ICU stay. Diabetes mellitus was a pre-existing co-morbidity in 913 patients (22.2% of patients with AHRF). In multivariable analysis, there was no association between diabetes mellitus and having ARDS (OR 0.93 (0.78-1.11); p = 0.39), developing ARDS late (OR 0.79 (0.54-1.15); p = 0.22), or hospital mortality in patients with ARDS (1.15 (0.93-1.42); p = 0.19). In a matched sample of patients, there was no association between diabetes mellitus and outcomes of interest. Conclusions: In a large, global observational study of patients with AHRF, no association was found between diabetes mellitus and having ARDS, developing ARDS, or outcomes from ARDS. Trial registration: NCT02010073. Registered on 12 December 2013
Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries
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- Abe T
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- Adams JC
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- Al Dorzi HM
- Al Jabbary AS
- Albaiceta GM
- Albarrak MM
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- Alda RS
- Alejandro RV
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- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2018
- Field of study
Background: To better understand the epidemiology and patterns of tracheostomy practice for patients with acute respiratory distress syndrome (ARDS), we investigated the current usage of tracheostomy in patients with ARDS recruited into the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG-SAFE) study. Methods: This is a secondary analysis of LUNG-SAFE, an international, multicenter, prospective cohort study of patients receiving invasive or noninvasive ventilation in 50 countries spanning 5 continents. The study was carried out over 4 weeks consecutively in the winter of 2014, and 459 ICUs participated. We evaluated the clinical characteristics, management and outcomes of patients that received tracheostomy, in the cohort of patients that developed ARDS on day 1-2 of acute hypoxemic respiratory failure, and in a subsequent propensity-matched cohort. Results: Of the 2377 patients with ARDS that fulfilled the inclusion criteria, 309 (13.0%) underwent tracheostomy during their ICU stay. Patients from high-income European countries (n = 198/1263) more frequently underwent tracheostomy compared to patients from non-European high-income countries (n = 63/649) or patients from middle-income countries (n = 48/465). Only 86/309 (27.8%) underwent tracheostomy on or before day 7, while the median timing of tracheostomy was 14 (Q1-Q3, 7-21) days after onset of ARDS. In the subsample matched by propensity score, ICU and hospital stay were longer in patients with tracheostomy. While patients with tracheostomy had the highest survival probability, there was no difference in 60-day or 90-day mortality in either the patient subgroup that survived for at least 5 days in ICU, or in the propensity-matched subsample. Conclusions: Most patients that receive tracheostomy do so after the first week of critical illness. Tracheostomy may prolong patient survival but does not reduce 60-day or 90-day mortality. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013
Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study
- Author
- Abad Ricardo Diaz
- Abe Toshikazu
- Abroug Fekri
- Adams John C.
- Adamsson Richard O.
- Adolfsson Anne
- Aguilar Ronald Zumaran
- Aguirre Janet S.
- Aguirre-Bermeo Hernan
- Aisa Tharwat M.
- Aisiku Imo
- Ajetunmobi Olaitan O.
- Aker Mustafa
- Akyol Onat O.
- Al Dorzi Hasan M.
- Al Jabbary Ahmed S.
- Albaiceta Guillermo M.
- Albarrak Mohamad M.
- Albiero Daniela
- Alda Rosa S.
- Alejandro Risso V.
- Alexander Peter
- Algaba Ángela
- Aliaga Felipe A.
- Alisasis Alain U.
- Allan Russell M.
- Allue Raquel Montoiro
- Almekhlafi Ghaleb
- Alonso Javier G.
- Altaf Wahid
- Alvarez António M.
- Alvarez Javier
- Amin Pravin
- Amir Fahd
- Amor Abdellatif Benslama Mourad
- An Youzhong
- Andersen Finn H.
- Andoh Kohkichi
- Andruszkiewicz Pawel
- Aneman Anders
- Antonelli Massimo M.
- Antônio Ana Carolina P.
- Aoki Nobumasa
- Appelberg Henrik
- Arabi Yaasen
- Arabi Yaseen M.
- Araujo Ana M.
- Arizmendi Alfons
- Arnal Jean-Michel
- Artiga Maria Jose D.
- Artigas Antonio
- Ascoli Aline
- Au Siu-Ming
- Avila Luis E.
- Azad Raman
- Azevedo Luciano Cesar
- Baboi Loredana
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- Bailey Irene M.
- Bailey Mathew B.
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- Balkhi Hicham
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- Poblano Manuel
- Poli Michela M.
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- Pozo Norberto C.
- Pozzi Matteo
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- Pronovost Antoine
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- Vinzio Mauricio
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- Wang Hua X.
- Wang Shou H.
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- Yamaguchi Osamu
- Yamaji Yoshihiro
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- Yeatts Dale J.
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- Yu Tao
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- Zani Gianluca
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- Zeggwagh Amine Ali
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- Zender Hervé O.
- Zhai Zhe
- Zhang Fan
- Zhang Xing Y.
- Zhao Huiying
- Zhao Jun
- Zhao Xian Y.
- Zheng Ruiqiang
- Zhou Fa C.
- Zhou Suming
- Zhu Bao H.
- Zhu Wei H.
- Zogheib Elie H.
- Ñamendys-Silva Silvio A.
- Ünal Necmettin
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2020
- Field of study
Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.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 of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe
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