Home
|
Inbox
|
Search
|
View Abstract
Ventilator Management in ARDS: A Single Academic Center Experience
Description
.abstract img { width:300px !important; height:auto; display:block; text-align:center; margin-top:10px } .abstract { overflow-x:scroll } .abstract table { width:100%; display:block; border:hidden; border-collapse: collapse; margin-top:10px } .abstract td, th { border-top: 1px solid #ddd; padding: 4px 8px; } .abstract tbody tr:nth-child(even) td { background-color: #efefef; } .abstract a { overflow-wrap: break-word; word-wrap: break-word; }
A5066 - Ventilator Management in ARDS: A Single Academic Center Experience
Author Block: A. Damodaran1, J. E. Kuppy1, N. Levytska1, S. Sanyal1, J. G. Garcia2, S. M. Dudek1, P. G. Belvitch1; 1University of Illinois at Chicago, Chicago, IL, United States, 2University of Arizona, Tucson, AZ, United States.
Objective. Acute respiratory distress syndrome (ARDS) is a severe consequence of infection or other inflammatory stimuli and is associated with significant morbidity and mortality. However, the underlying pathophysiology remains incompletely elucidated, which has hindered accurate diagnosis and effective treatment. As part of an ongoing study at our institution, we are collecting clinical information and blood samples from DNA, RNA and protein analysis in order to create a repository of ARDS and control patient samples that can aid in identifying potential ARDS biomarkers. The current study is an initial description of the clinical characteristics of the patients enrolled over a three-year period from 2010 to 2013.
Methods and Results. Our patient sample is a single center cohort comprised of 53 patients admitted to our medical intensive care unit between August 2010 and June 2013. Data obtained from a retrospective chart review of the subjects include age, reason for ICU admission, length of ICU stay, mortality, ventilator settings and other parameters. The average age of the subjects in this cohort was 52 years. The average length of ICU stay was 10.7 days, and 17 of the subjects died during their ICU stay. Twenty seven of these subjects had ARDS, and the mortality among these ARDS subjects was 59%. The majority of these subjects with ARDS was concurrently diagnosed with either septic shock, acute pancreatitis, and/or decompensated liver cirrhosis. Of the 41 subjects in the total cohort requiring mechanical ventilation, the average duration of ventilation was 12.5 days. All of these subjects were maintained on volume control ventilation for at least part of their time spent intubated, and three of these subjects were also ventilated with airway pressure release ventilation. Among ARDS patients, 14 of 27 patients (52%) received a tidal volume of 6 mL/kg ideal body weight or less for some duration during their time intubated. The mortality rate among the ARDS subjects receiving low tidal volume ventilation was higher compared those not receiving low tidal volume ventilation (64% versus 46%).
Conclusions. In this retrospective analysis of a medical ICU cohort from our institution, adherence to lung-protective ventilation with low tidal volumes was poor, consistent with recent observations made in the multicenter, multinational LUNG-SAFE study. These data will help identify areas of potential improvement in ARDS care and the barriers preventing optimal treatment of this devastating condition.
Author Block: A. Damodaran1, J. E. Kuppy1, N. Levytska1, S. Sanyal1, J. G. Garcia2, S. M. Dudek1, P. G. Belvitch1; 1University of Illinois at Chicago, Chicago, IL, United States, 2University of Arizona, Tucson, AZ, United States.
Objective. Acute respiratory distress syndrome (ARDS) is a severe consequence of infection or other inflammatory stimuli and is associated with significant morbidity and mortality. However, the underlying pathophysiology remains incompletely elucidated, which has hindered accurate diagnosis and effective treatment. As part of an ongoing study at our institution, we are collecting clinical information and blood samples from DNA, RNA and protein analysis in order to create a repository of ARDS and control patient samples that can aid in identifying potential ARDS biomarkers. The current study is an initial description of the clinical characteristics of the patients enrolled over a three-year period from 2010 to 2013.
Methods and Results. Our patient sample is a single center cohort comprised of 53 patients admitted to our medical intensive care unit between August 2010 and June 2013. Data obtained from a retrospective chart review of the subjects include age, reason for ICU admission, length of ICU stay, mortality, ventilator settings and other parameters. The average age of the subjects in this cohort was 52 years. The average length of ICU stay was 10.7 days, and 17 of the subjects died during their ICU stay. Twenty seven of these subjects had ARDS, and the mortality among these ARDS subjects was 59%. The majority of these subjects with ARDS was concurrently diagnosed with either septic shock, acute pancreatitis, and/or decompensated liver cirrhosis. Of the 41 subjects in the total cohort requiring mechanical ventilation, the average duration of ventilation was 12.5 days. All of these subjects were maintained on volume control ventilation for at least part of their time spent intubated, and three of these subjects were also ventilated with airway pressure release ventilation. Among ARDS patients, 14 of 27 patients (52%) received a tidal volume of 6 mL/kg ideal body weight or less for some duration during their time intubated. The mortality rate among the ARDS subjects receiving low tidal volume ventilation was higher compared those not receiving low tidal volume ventilation (64% versus 46%).
Conclusions. In this retrospective analysis of a medical ICU cohort from our institution, adherence to lung-protective ventilation with low tidal volumes was poor, consistent with recent observations made in the multicenter, multinational LUNG-SAFE study. These data will help identify areas of potential improvement in ARDS care and the barriers preventing optimal treatment of this devastating condition.
|
Home
|
Inbox
|
Search
|