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

Detalhes bibliográficos
Autor(a) principal: Pisani, Luigi
Data de Publicação: 2022
Outros Autores: Algera, Anna Geke, Neto, Ary Serpa, Azevedo, Luciano, Pham, Tài, Paulus, Frederique, Abreu, Marcelo Gama de, Pelosi, Paolo, Dondorp, Arjen M., Bellani, Giacomo, Laffey, John G., Schultz, Marcus J.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/53482
Resumo: André Miguel Japiassú. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.
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spelling Pisani, LuigiAlgera, Anna GekeNeto, Ary SerpaAzevedo, LucianoPham, TàiPaulus, FrederiqueAbreu, Marcelo Gama dePelosi, PaoloDondorp, Arjen M.Bellani, GiacomoLaffey, John G.Schultz, Marcus J.2022-06-26T18:27:37Z2022-06-26T18:27:37Z2022PISANI, Luigi et al. 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. The Lancet. Global health, v. 10, n. 2, p. e227-e235, 20222214-109Xhttps://www.arca.fiocruz.br/handle/icict/5348210.1016/S2214-109X(21)00485-XAndré Miguel Japiassú. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.Academic Medical Center. Amsterdam University Medical Centers. Department of Intensive Care. Amsterdam, Netherlands / Mahidol University. Faculty of Tropical Medicine. Mahidol-Oxford Tropical Medicine Research Unit. Bangkok, Thailand / CUAMM. Doctors with Africa. Section of Operative Research. Padova, Italy / Miulli Regional General Hospital. Department of Intensive Care. Bari, ItalyAcademic Medical Center. Amsterdam University Medical Centers. Department of Intensive Care. Amsterdam, Netherlands.Monash University. School of Public Health and Preventive Medicine. Australia / New Zealand Intensive Care Research Centre. Melbourne, VIC, Australia / University of Melbourne. Austin Hospital. Melbourne Medical School. Department of Critical Care. Melbourne, Australia / Austin Hospital. Data Analytics Research and Evaluation Centre. Melbourne, VIC, Australia / Hospital Israelita Albert Einstein. Department of Critical Care Medicine. São Paulo, SP, Brazil.Universidade de São Paulo. Faculdade de Medicina. Hospital das Clinicas HCFMUSP. Department of Critical Care Medicine. São Paulo, SP, Brazil.St Michael's Hospital. Li Ka Shing Knowledge Institute. Keenan Research Centre for Biomedical Science. Toronto, ON, Canada / University of Toronto. Interdepartmental Division of Critical Care Medicine. Toronto, ON, Canada.Academic Medical Center. Amsterdam University Medical Centers. Department of Intensive Care. Amsterdam, Netherlands.University Hospital Carl Gustav Carus and Technical University Dresden. Department of Anaesthesiology and Intensive Care Medicine. Pulmonary Engineering Group. Dresden, Germany.University of Genoa. San Martino Policlinico Hospital IRCCS for Oncology. Department of Surgical Sciences and Integrated Diagnostics. Genoa, Italy.Mahidol University. Faculty of Tropical Medicine. Mahidol-Oxford Tropical Medicine Research Unit. Bangkok, Thailand / University of Oxford. Nuffield Department of Medicine. Oxford, UK.University of Milan Bicocca. Department of Intensive Care. Monza, Italy / University of Milan Bicocca. Department of Medicine and Surgery. Monza, Italy / San Gerardo Hospital. Department of Emergency and Intensive Care. Monza, Italy.National University of Ireland and Galway University Hospitals Ireland. School of Medicine. Anaesthesia and Intensive Care Medicine. Galway, Ireland / National University of Ireland and Galway University Hospitals Ireland. Regenerative Medicine Institute at CÚRAM Centre for Research in Medical Devices. Galway, Ireland.Academic Medical Center. Amsterdam University Medical Centers. Department of Intensive Care. Amsterdam, Netherlands / Academic Medical Center. Amsterdam University Medical Centers. Laboratory of Experimental Intensive Care and Anaesthesiology. Amsterdam, Netherlands / Mahidol University. Faculty of Tropical Medicine. Mahidol-Oxford Tropical Medicine Research Unit. Bangkok, Thailand / University of Oxford. Nuffield Department of Medicine. Oxford, UK.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.engElsevierGeoeconomic 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 studiesinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleAcute respiratory distress syndromeIntensive care unitLow tidal volume ventilationInvasively ventilationinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; 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dc.title.pt_BR.fl_str_mv 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
title 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
spellingShingle 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
Pisani, Luigi
Acute respiratory distress syndrome
Intensive care unit
Low tidal volume ventilation
Invasively ventilation
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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 Pisani, Luigi
author_facet Pisani, Luigi
Algera, Anna Geke
Neto, Ary Serpa
Azevedo, Luciano
Pham, Tài
Paulus, Frederique
Abreu, Marcelo Gama de
Pelosi, Paolo
Dondorp, Arjen M.
Bellani, Giacomo
Laffey, John G.
Schultz, Marcus J.
author_role author
author2 Algera, Anna Geke
Neto, Ary Serpa
Azevedo, Luciano
Pham, Tài
Paulus, Frederique
Abreu, Marcelo Gama de
Pelosi, Paolo
Dondorp, Arjen M.
Bellani, Giacomo
Laffey, John G.
Schultz, Marcus J.
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Pisani, Luigi
Algera, Anna Geke
Neto, Ary Serpa
Azevedo, Luciano
Pham, Tài
Paulus, Frederique
Abreu, Marcelo Gama de
Pelosi, Paolo
Dondorp, Arjen M.
Bellani, Giacomo
Laffey, John G.
Schultz, Marcus J.
dc.subject.en.pt_BR.fl_str_mv Acute respiratory distress syndrome
Intensive care unit
Low tidal volume ventilation
Invasively ventilation
topic Acute respiratory distress syndrome
Intensive care unit
Low tidal volume ventilation
Invasively ventilation
description André Miguel Japiassú. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.
publishDate 2022
dc.date.accessioned.fl_str_mv 2022-06-26T18:27:37Z
dc.date.available.fl_str_mv 2022-06-26T18:27:37Z
dc.date.issued.fl_str_mv 2022
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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status_str publishedVersion
dc.identifier.citation.fl_str_mv PISANI, Luigi et al. 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. The Lancet. Global health, v. 10, n. 2, p. e227-e235, 2022
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/53482
dc.identifier.issn.pt_BR.fl_str_mv 2214-109X
dc.identifier.doi.none.fl_str_mv 10.1016/S2214-109X(21)00485-X
identifier_str_mv PISANI, Luigi et al. 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. The Lancet. Global health, v. 10, n. 2, p. e227-e235, 2022
2214-109X
10.1016/S2214-109X(21)00485-X
url https://www.arca.fiocruz.br/handle/icict/53482
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
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reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/53482/1/license.txt
https://www.arca.fiocruz.br/bitstream/icict/53482/2/Geoeconomic_Andre_Japiassu_etal_INI_2022.pdf
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