Effects of Transthoracic Echocardiography on the Prognosis of Patients with Acute Respiratory Distress Syndrome: A Propensity Score Matched Analysis of the MIMIC-III Database

Abstract Introduction: Acute respiratory distress syndrome (ARDS) has high mortality and is mainly related to the circulatory failure.Therefore, real-time monitoring of cardiac function and structural changes has important clinical significance.Transthoracic echocardiography (TTE) is a simple and noninvasive real-time cardiac examination which is widely used in intensive care unit (ICU) patients.The purpose of this study was to analyze the effect of TTE on the prognosis of ICU patients with ARDS.Methods: The data of ARDS patients were retrieved from the MIMIC-III v1.4 database and patients were divided into the TTE group and non-TTE group. Then, the baseline data were compared between the two groups, and the effect of TTE on the prognosis of ARDS patients was analyzed through multivariate logistic analysis and the propensity score (PS).Results: A total of 1,346 ARDS patients were enrolled, including 519 (38.6%) cases in the TTE group and 827 (61.4%) cases in the non-TTE group. Compared with the non-TTE group, the 28-day mortality of patients in the TTE group was greatly improved (OR=0.64 95%CI: 0.48-0.86, P=0.003). The length of ICU stay in the TTE group was significantly shorter than that in the non-TTE group (17d vs.14d, P=0.0001). The infusion volume in the TTE group was significantly less than that of the non-TTE group (6.2L vs.5.5L on day 1, P=0.0012). Importantly, the patients in the TTE group were weaned ventilators earlier than those in the non-TTE group (ventilator-free days within 28 d: 21 d vs. 19.8 d, respectively, P = 0.071).Conclusion: TTE can lower the risk of 28-d mortality in patients with ARDS.

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Comparative Efficacy of Fentanyl and Morphine in Patients with or At Risk for Acute Respiratory Distress Syndrome: A Propensity Score-Matched Cohort Study

Drugs in R&D ◽

10.1007/s40268-021-00338-3 ◽

2021 ◽

Author(s):

An-Min Hu ◽

Zhi-Ming Shan ◽

Zhong-Jun Zhang ◽

Hui-Ping Li

Keyword(s):

At Risk ◽

Acute Respiratory Distress Syndrome ◽

Cohort Study ◽

Propensity Score ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Matched Cohort ◽

Comparative Efficacy ◽

Matched Cohort Study

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Adjustment for Propensity Score in Nonrandomized Clinical Studies: Comparison of Sivelestat Versus Conventional Therapy for Acute Lung Injury in Acute Respiratory Distress Syndrome

Therapeutic Innovation & Regulatory Science ◽

10.1177/2168479016659103 ◽

2017 ◽

Vol 51 (1) ◽

pp. 89-99 ◽

Cited By ~ 1

Author(s):

Satoru Fukimbara ◽

Kouji Niibe ◽

Michio Yamamoto ◽

Takuhiro Yamaguchi

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Acute Lung Injury ◽

Propensity Score ◽

Lung Injury ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Clinical Studies ◽

Conventional Therapy ◽

Distress Syndrome

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Comparative Effectiveness of Midazolam, Propofol, and Dexmedetomidine in Patients With or at Risk for Acute Respiratory Distress Syndrome: A Propensity Score-Matched Cohort Study

Frontiers in Pharmacology ◽

10.3389/fphar.2021.614465 ◽

2021 ◽

Vol 12 ◽

Author(s):

An-Min Hu ◽

Xiong-Xiong Zhong ◽

Zhen Li ◽

Zhong-Jun Zhang ◽

Hui-Ping Li

Keyword(s):

At Risk ◽

Mechanical Ventilation ◽

Acute Respiratory Distress Syndrome ◽

Propensity Score ◽

Hospital Mortality ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Research Database ◽

Matched Cohort

Background: Sedatives are commonly used in patients with or at risk for acute respiratory distress syndrome (ARDS) during mechanical ventilation. To systematically compare the outcomes of sedation with midazolam, propofol, and dexmedetomidine in patients with or at risk for ARDS.Methods: We developed a dataset of real-world data to enable the comparison of the effectiveness and safety of sedatives and the associated outcomes from the MIMIC-III database and the eICU Collaborative Research database. We performed a systematic study with six cohorts to estimate the relative risks of outcomes among patients administered different sedatives. Propensity score matching was performed to generate a balanced 1:1 matched cohort and to identify potential prognostic factors. The outcomes included hospital mortality, duration of mechanical ventilation, length of intensive care unit stay, length of hospitalization, and likelihood of being discharged home.Results: We performed 60 calibrated analyses among all groups and outcomes with 17,410 eligible patients. Sedation with dexmedetomidine was associated with a lower in-hospital mortality rate than sedation with midazolam and propofol or sedation without dexmedetomidine (p < 0.001). When compared with no sedation, the use of midazolam, propofol or dexmedetomidine was associated with a longer ICU stay and longer hospitalization duration (p < 0.01). Patients treated with midazolam were relatively less likely to be discharged home (p < 0.05).Conclusion: Patients treated with dexmedetomidine had a reduced risk of mortality. These data suggest that dexmedetomidine may be the preferred sedative in patients with or at risk for ARDS.

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Early Prone Positioning in Acute Respiratory Distress Syndrome Related to COVID-19: A Propensity Score Analysis from the Multicentric Cohort COVID-ICU network. The ProneCOVID Study.

10.21203/rs.3.rs-895727/v1 ◽

2021 ◽

Author(s):

Christophe LE TERRIER ◽

Florian Sigaud ◽

Said Lebbah ◽

Luc Desmedt ◽

David Hajage ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Propensity Score ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Propensity Score Analysis ◽

Prone Positioning ◽

Icu Admission ◽

Significant Difference ◽

The Impact

Abstract Background Delaying time to prone positioning (PP) may be associated with higher mortality in acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19). We evaluated the use and the impact of early PP on clinical outcomes in intubated patients hospitalized in intensive care units (ICUs) for COVID-19.Methods All intubated patients with ARDS due to COVID-19 were involved in a secondary analysis from a prospective multicenter cohort study of COVID-ICU network including 149 ICUs across France, Belgian and Switzerland. Patients were followed-up until Day-90. The primary outcome was survival at Day-60. Analysis used a Cox proportional hazard model including a propensity score. Results Among 2137 intubated patients, 1504 (70.4%) were placed in PP during their ICU stay, and 491 (23%) during the first 24 hrs following ICU admission. One hundred and eighty-one patients (36.9%) of the early PP group had a PaO2/FiO2 ratio > 150 mmHg when prone positioning was initiated. Among non-early PP group patients, 1013 (47.4%) patients had finally been placed in PP within a median delay of 3 days after ICU admission. Day-60 mortality in non-early PP group was 34.2% vs. 39.3% in the early PP group (p = 0.038). Day-28 and Day-90 mortality as well as the need for adjunctive therapies were more important in patients with early PP. After propensity score adjustment, no significant difference in survival at Day-60 was found between the two-study groups (HR 1.34 [0.96-1.68], p=0.09 and HR 1.19 [0.998-1.412], p=0.053 in complete case analysis or in multiple imputation analysis, respectively).Conclusions In a large multicentric international cohort of intubated ICU patients with ARDS due to COVID-19, PP has been used frequently as a main treatment. In this study, early PP started within 24 hrs after ICU admission was not associated with a survival benefit compared to PP after day 1.

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CELLULAR-STRUCTURAL CHANGES IN THE MYOCARDIUM IN EXPERIMENTAL ACUTE RESPIRATORY DISTRESS SYNDROME

Clinical anatomy and operative surgery ◽

10.24061/1727-0847.10.3.2011.4 ◽

2011 ◽

Vol 10 (3) ◽

pp. 27-29

Author(s):

A. V. Dobrorodniy

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Structural Changes ◽

Distress Syndrome

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Adjunctive therapy with azithromycin for moderate and severe acute respiratory distress syndrome: a retrospective, propensity score-matching analysis of prospectively collected data at a single center

International Journal of Antimicrobial Agents ◽

10.1016/j.ijantimicag.2018.02.009 ◽

2018 ◽

Vol 51 (6) ◽

pp. 918-924 ◽

Cited By ~ 18

Author(s):

Kodai Kawamura ◽

Kazuya Ichikado ◽

Makoto Takaki ◽

Yoshitomo Eguchi ◽

Keisuke Anan ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Propensity Score ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Propensity Score Matching ◽

Adjunctive Therapy ◽

Distress Syndrome ◽

Single Center ◽

Propensity Score Matching Analysis

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Neuromuscular Function in Survivors of the Acute Respiratory Distress Syndrome

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100007307 ◽

2007 ◽

Vol 34 (4) ◽

pp. 427-432 ◽

Cited By ~ 29

Author(s):

Michael J. Angel ◽

Vera Bril ◽

Patrick Shannon ◽

Margaret S. Herridge

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Structural Changes ◽

Functional Disability ◽

Distress Syndrome ◽

Critical Illness Polyneuropathy ◽

Organic Basis ◽

Electrodiagnostic Testing ◽

Icu Discharge

Background:Survivors of acute respiratory distress syndrome (ARDS) report generalized weakness and reduced exercise tolerance up to two years following discharge from the intensive care unit (ICU). Persistent neuromuscular complications of ARDS may contribute to the functional disability observed in these patients.Methods:Sixteen ARDS survivors underwent comprehensive neurological evaluation and standardized electrodiagnostic testing 6 to 24 months after ICU discharge. Four of these patients agreed to open muscle biopsy.Results:Seven of sixteen patients had clinically significant focal compressive mononeuropathies. Electrodiagnostic testing failed to reveal any changes attributable to critical illness polyneuropathy or myopathy. All four muscle biopsies were abnormal, and although the pathological features were structurally non-specific, the presence of an acquired myopathy remains possible. Four patients had persistent mixed sensory complaints but had normal electrodiagnostic evaluation.Conclusions:The high frequency of mononeuropathies highlights the need for vigilance in daily ICU care. The findings also suggest that complaints of weakness and reduced exercise capacity in ARDS survivors may be related to combined effects of compressive neuropathies and generalized longstanding structural changes in muscle and may support an organic basis for longterm functional disability.

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Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome: Propensity Score Matching

Membranes ◽

10.3390/membranes11060393 ◽

2021 ◽

Vol 11 (6) ◽

pp. 393

Author(s):

Li-Chung Chiu ◽

Li-Pang Chuang ◽

Shaw-Woei Leu ◽

Yu-Jr Lin ◽

Chee-Jen Chang ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Mortality Rate ◽

Propensity Score ◽

Extracorporeal Membrane Oxygenation ◽

Hospital Mortality ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Propensity Score Matching ◽

Distress Syndrome ◽

Membrane Oxygenation

The high mortality rate of patients with severe acute respiratory distress syndrome (ARDS) warrants aggressive clinical intervention. Extracorporeal membrane oxygenation (ECMO) is a salvage therapy for life-threatening hypoxemia. Randomized controlled trials of ECMO for severe ARDS comprise a number of ethical and methodological issues. Therefore, indications and optimal timing for implementation of ECMO, and predictive risk factors for outcomes have not been adequately investigated. We performed propensity score matching to match ECMO-supported and non-ECMO-supported patients at 48 h after ARDS onset for comparisons based on clinical outcomes and hospital mortality. A total of 280 severe ARDS patients were included, and propensity score matching of 87 matched pairs revealed that the 90-d hospital mortality rate was 56.3% in the ECMO group and 74.7% in the non-ECMO group (p = 0.028). Subgroup analysis revealed that greater severity of ARDS, higher airway pressure, or a higher Sequential Organ Failure Assessment score tended to benefit from ECMO treatment in terms of survival. Multivariate logistic regression revealed that hospital mortality was significantly lower among patients who received ECMO than among those who did not. Our findings suggested that early initiation of ECMO (within 48 h) may increase the likelihood of survival for patients with severe ARDS.

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