Mechanical power in acute respiratory distress syndrome : A possible modeling of mortality prediction

2017 ◽  
Vol 42 ◽  
pp. 383
Author(s):  
Leandro Oliveira Dellacqua ◽  
Augusto Cezar Marins Gomes ◽  
Marina Costa Cavallaro ◽  
Marcelo Park
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Mortality Prediction ◽  
Mechanical Power

scholarly journals The Value of Oxygenation Saturation Index in Predicting the Outcomes of Patients with Acute Respiratory Distress Syndrome

2018 ◽  
Vol 7 (8) ◽  
pp. 205 ◽  
Author(s):  
Wan-Ling Chen ◽  
Wei-Ting Lin ◽  
Shu-Chen Kung ◽  
Chih-Cheng Lai ◽  
Chien-Ming Chao
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Saturation Index ◽  
Predictive Performance ◽  
Mortality Prediction ◽  
Apache Ii Score ◽  
Operating Characteristics ◽  
Adult Intensive Care Unit

This study aims to investigate the association between oxygenation saturation index (OSI) and the outcome of acute respiratory distress syndrome (ARDS) patients, and assess the predictive performance of OSI for ARDS patients’ mortality. This study was conducted at one regional hospital with 66 adult intensive care unit (ICU) beds. All patients with ARDS were identified between November 1 2016 and May 31 2018, and their clinical information was retrospectively collected. The lowest PaO2/FiO2 ratio and SpO2/FiO2 ratio and highest mean airway pressure (MAP) were recorded on the first day of ARDS; and oxygen index (OI) and OSI were calculated as (FiO2 × MAP × 100)/PaO2, and (FiO2 × MAP × 100) /SpO2 accordingly. During the study period, a total of 101 patients with ARDS were enrolled, and their mean age was 69.2 years. The overall in-ICU and in-hospital mortality rate was 57.4% and 61.4%, respectively. The patients with in-ICU mortality had higher APACHE II score than the survivors (31.6 ± 9.8 vs. 23.0 ± 9.1, p < 0.001). In addition, mortalities had lower SpO2, and SpO2/FiO2 ratios than the survivors (both p < 0.05). In contrast, survivors had lower OI, and OSI than the mortalities (both p = 0.008). Both OSI (area under curve (AUC) = 0.656, p = 0.008) and OI (AUC = 0.654, p = 0.008) had good predictive performance of mortality among ARDS patients using receiver-operating characteristics (ROC) curves analysis. In addition, the AUC of SpO2/FiO2 (AUC = 0.616, p = 0.046) had better performance for mortality prediction than PaO2/FiO2 (AUC = 0.603, p = 0.08). The patients with OSI greater than 12 had a higher risk of mortality than OSI < 12 (adjusted OR, 5.22, 95% CI, 1.31–20.76, p = 0.019). In contrast, OI, PaO2/FiO2, and SpO2/FiO2 were not found to be significantly associated with increased mortality. OSI is significantly associated with the increased mortality of ARDS patients and can also be a good outcome predictor.

Long noncoding plasmacytoma variant translocation 1 facilitates the surveillance of acute respiratory distress syndrome and mortality prediction in sepsis

2021 ◽  
Vol 15 (6) ◽  
pp. 401-412
Author(s):  
Yijue Liu ◽  
Huan Peng ◽  
Feng Gui
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Disease Severity ◽  
Noncoding Rna ◽  
Distress Syndrome ◽  
Mortality Prediction ◽  
Prediction Of Mortality ◽  
Failure Assessment ◽  
Variant Translocation

Aim: We aimed to investigate the association of long noncoding RNA plasmacytoma variant translocation 1 (lncRNA PVT1) expression with acute respiratory distress syndrome (ARDS) risk and its prognostic value for 28-day mortality in sepsis patients. Materials & methods: LncRNA PVT1 expression from 109 sepsis patients and 100 health controls was detected. General sepsis severity was assessed using acute physiology and chronic health evaluation II score and sequential organ failure assessment score. Results: LncRNA PVT1 had an acceptable predictive value for higher ARDS risk, then was identified as an independent risk factor for sepsis ARDS; LncRNA PVT1 expression positively correlated with general disease severity in sepsis patients; LncRNA PVT1 was overexpressed in 28-day deaths compared with 28-day survivors in sepsis patients. Conclusion: LncRNA PVT1 may facilitate the surveillance of ARDS, general disease severity and the prediction of mortality in sepsis patients.

scholarly journals Evaluation of Positive End-Expiratory Pressure Strategies in Patients With Coronavirus Disease 2019–Induced Acute Respiratory Distress Syndrome

2021 ◽  
Vol 8 ◽  
Author(s):  
Chun Pan ◽  
Cong Lu ◽  
Xiaobin She ◽  
Haibo Ren ◽  
Huazhang Wei ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Respiratory Mechanics ◽  
Plateau Pressure ◽  
Mechanical Power ◽  
Positive End Expiratory Pressure ◽  
The One ◽  
Compliance Strategy

Background: Different positive end-expiratory pressure (PEEP) strategies are available for subjects with coronavirus disease 2019 (COVID-19)–induced acute respiratory distress syndrome (ARDS) requiring invasive mechanical ventilation. We aimed to evaluate three conventional PEEP strategies on their effects on respiratory mechanics, gas exchanges, and hemodynamics.Methods: This is a prospective, physiologic, multicenter study conducted in China. We recruited 20 intubated subjects with ARDS and confirmed COVID-19. We first set PEEP by the ARDSnet low PEEP–fraction of inspired oxygen (FIO2) table. After a recruitment maneuver, PEEP was set at 15, 10, and 5 cm H2O for 10 min, respectively. Among these three PEEP levels, best-compliance PEEP was the one providing the highest respiratory system compliance; best-oxygenation PEEP was the one providing the highest PaO2 (partial pressure of arterial oxygen)/FIO2.Results: At each PEEP level, we assessed respiratory mechanics, arterial blood gas, and hemodynamics. Among three PEEP levels, plateau pressure, driving pressure, mechanical power, and blood pressure improved with lower PEEP. The ARDSnet low PEEP–FIO2 table and the best-oxygenation strategies provided higher PEEP than the best-compliance strategy (11 ± 6 cm H2O vs. 11 ± 3 cm H2O vs. 6 ± 2 cm H2O, p = 0.001), leading to higher plateau pressure, driving pressure, and mechanical power. The three PEEP strategies were not significantly different in gas exchange. The subgroup analysis showed that three PEEP strategies generated different effects in subjects with moderate or severe ARDS (n = 12) but not in subjects with mild ARDS (n = 8).Conclusions: In our cohort with COVID-19–induced ARDS, the ARDSnet low PEEP/FIO2 table and the best-oxygenation strategies led to higher PEEP and potentially higher risk of ventilator-induced lung injury than the best-compliance strategy.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04359251.

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