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Associations between ventilator settings during extracorporeal membrane oxygenation for refractory hypoxemia and outcome in patients with acute respiratory distress syndrome: a pooled individual patient data analysis

Standard

Associations between ventilator settings during extracorporeal membrane oxygenation for refractory hypoxemia and outcome in patients with acute respiratory distress syndrome: a pooled individual patient data analysis : Mechanical ventilation during ECMO. / Serpa Neto, Ary; Schmidt, Matthieu; Azevedo, Luciano C P; Bein, Thomas; Brochard, Laurent; Beutel, Gernot; Combes, Alain; Costa, Eduardo L V; Hodgson, Carol; Lindskov, Christian; Lubnow, Matthias; Lueck, Catherina; Michaels, Andrew J; Paiva, Jose-Artur; Park, Marcelo; Pesenti, Antonio; Pham, Tài; Quintel, Michael; Ranieri, V Marco; Ried, Michael; Roncon-Albuquerque, Roberto; Slutsky, Arthur S; Takeda, Shinhiro; Terragni, Pier Paolo; Vejen, Marie; Weber-Carstens, Steffen; Welte, Tobias; Gama de Abreu, Marcelo; Pelosi, Paolo; Schultz, Marcus J; ReVA Research Network and the PROVE Network Investigators.

in: INTENS CARE MED, Jahrgang 42, Nr. 11, 11.2016, S. 1672-1684.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Serpa Neto, A, Schmidt, M, Azevedo, LCP, Bein, T, Brochard, L, Beutel, G, Combes, A, Costa, ELV, Hodgson, C, Lindskov, C, Lubnow, M, Lueck, C, Michaels, AJ, Paiva, J-A, Park, M, Pesenti, A, Pham, T, Quintel, M, Ranieri, VM, Ried, M, Roncon-Albuquerque, R, Slutsky, AS, Takeda, S, Terragni, PP, Vejen, M, Weber-Carstens, S, Welte, T, Gama de Abreu, M, Pelosi, P, Schultz, MJ & ReVA Research Network and the PROVE Network Investigators 2016, 'Associations between ventilator settings during extracorporeal membrane oxygenation for refractory hypoxemia and outcome in patients with acute respiratory distress syndrome: a pooled individual patient data analysis: Mechanical ventilation during ECMO', INTENS CARE MED, Jg. 42, Nr. 11, S. 1672-1684. https://doi.org/10.1007/s00134-016-4507-0

APA

Serpa Neto, A., Schmidt, M., Azevedo, L. C. P., Bein, T., Brochard, L., Beutel, G., Combes, A., Costa, E. L. V., Hodgson, C., Lindskov, C., Lubnow, M., Lueck, C., Michaels, A. J., Paiva, J-A., Park, M., Pesenti, A., Pham, T., Quintel, M., Ranieri, V. M., ... ReVA Research Network and the PROVE Network Investigators (2016). Associations between ventilator settings during extracorporeal membrane oxygenation for refractory hypoxemia and outcome in patients with acute respiratory distress syndrome: a pooled individual patient data analysis: Mechanical ventilation during ECMO. INTENS CARE MED, 42(11), 1672-1684. https://doi.org/10.1007/s00134-016-4507-0

Vancouver

Serpa Neto A, Schmidt M, Azevedo LCP, Bein T, Brochard L, Beutel G et al. Associations between ventilator settings during extracorporeal membrane oxygenation for refractory hypoxemia and outcome in patients with acute respiratory distress syndrome: a pooled individual patient data analysis: Mechanical ventilation during ECMO. INTENS CARE MED. 2016 Nov;42(11):1672-1684. https://doi.org/10.1007/s00134-016-4507-0

Bibtex

@article{558a2f7dbd7d463282353409783651af,
title = "Associations between ventilator settings during extracorporeal membrane oxygenation for refractory hypoxemia and outcome in patients with acute respiratory distress syndrome: a pooled individual patient data analysis: Mechanical ventilation during ECMO",
abstract = "PURPOSE: Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for patients with acute respiratory distress syndrome (ARDS). The aim of this study was to evaluate associations between ventilatory settings during ECMO for refractory hypoxemia and outcome in ARDS patients.METHODS: In this individual patient data meta-analysis of observational studies in adult ARDS patients receiving ECMO for refractory hypoxemia, a time-dependent frailty model was used to determine which ventilator settings in the first 3 days of ECMO had an independent association with in-hospital mortality.RESULTS: Nine studies including 545 patients were included. Initiation of ECMO was accompanied by significant decreases in tidal volume size, positive end-expiratory pressure (PEEP), plateau pressure, and driving pressure (plateau pressure - PEEP) levels, and respiratory rate and minute ventilation, and resulted in higher PaO2/FiO2, higher arterial pH and lower PaCO2 levels. Higher age, male gender and lower body mass index were independently associated with mortality. Driving pressure was the only ventilatory parameter during ECMO that showed an independent association with in-hospital mortality [adjusted HR, 1.06 (95 % CI, 1.03-1.10)].CONCLUSION: In this series of ARDS patients receiving ECMO for refractory hypoxemia, driving pressure during ECMO was the only ventilator setting that showed an independent association with in-hospital mortality.",
keywords = "Adult, Age Factors, Body Mass Index, Extracorporeal Membrane Oxygenation/instrumentation, Female, Hospital Mortality, Humans, Hypoxia/therapy, Male, Middle Aged, Observational Studies as Topic, Positive-Pressure Respiration, Respiration, Artificial/methods, Respiratory Distress Syndrome/mortality, Sex Factors, Tidal Volume, Time Factors, Ventilators, Mechanical/standards",
author = "{Serpa Neto}, Ary and Matthieu Schmidt and Azevedo, {Luciano C P} and Thomas Bein and Laurent Brochard and Gernot Beutel and Alain Combes and Costa, {Eduardo L V} and Carol Hodgson and Christian Lindskov and Matthias Lubnow and Catherina Lueck and Michaels, {Andrew J} and Jose-Artur Paiva and Marcelo Park and Antonio Pesenti and T{\`a}i Pham and Michael Quintel and Ranieri, {V Marco} and Michael Ried and Roberto Roncon-Albuquerque and Slutsky, {Arthur S} and Shinhiro Takeda and Terragni, {Pier Paolo} and Marie Vejen and Steffen Weber-Carstens and Tobias Welte and {Gama de Abreu}, Marcelo and Paolo Pelosi and Schultz, {Marcus J} and {ReVA Research Network and the PROVE Network Investigators}",
year = "2016",
month = nov,
doi = "10.1007/s00134-016-4507-0",
language = "English",
volume = "42",
pages = "1672--1684",
journal = "INTENS CARE MED",
issn = "0342-4642",
publisher = "Springer",
number = "11",

}

RIS

TY - JOUR

T1 - Associations between ventilator settings during extracorporeal membrane oxygenation for refractory hypoxemia and outcome in patients with acute respiratory distress syndrome: a pooled individual patient data analysis

T2 - Mechanical ventilation during ECMO

AU - Serpa Neto, Ary

AU - Schmidt, Matthieu

AU - Azevedo, Luciano C P

AU - Bein, Thomas

AU - Brochard, Laurent

AU - Beutel, Gernot

AU - Combes, Alain

AU - Costa, Eduardo L V

AU - Hodgson, Carol

AU - Lindskov, Christian

AU - Lubnow, Matthias

AU - Lueck, Catherina

AU - Michaels, Andrew J

AU - Paiva, Jose-Artur

AU - Park, Marcelo

AU - Pesenti, Antonio

AU - Pham, Tài

AU - Quintel, Michael

AU - Ranieri, V Marco

AU - Ried, Michael

AU - Roncon-Albuquerque, Roberto

AU - Slutsky, Arthur S

AU - Takeda, Shinhiro

AU - Terragni, Pier Paolo

AU - Vejen, Marie

AU - Weber-Carstens, Steffen

AU - Welte, Tobias

AU - Gama de Abreu, Marcelo

AU - Pelosi, Paolo

AU - Schultz, Marcus J

AU - ReVA Research Network and the PROVE Network Investigators

PY - 2016/11

Y1 - 2016/11

N2 - PURPOSE: Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for patients with acute respiratory distress syndrome (ARDS). The aim of this study was to evaluate associations between ventilatory settings during ECMO for refractory hypoxemia and outcome in ARDS patients.METHODS: In this individual patient data meta-analysis of observational studies in adult ARDS patients receiving ECMO for refractory hypoxemia, a time-dependent frailty model was used to determine which ventilator settings in the first 3 days of ECMO had an independent association with in-hospital mortality.RESULTS: Nine studies including 545 patients were included. Initiation of ECMO was accompanied by significant decreases in tidal volume size, positive end-expiratory pressure (PEEP), plateau pressure, and driving pressure (plateau pressure - PEEP) levels, and respiratory rate and minute ventilation, and resulted in higher PaO2/FiO2, higher arterial pH and lower PaCO2 levels. Higher age, male gender and lower body mass index were independently associated with mortality. Driving pressure was the only ventilatory parameter during ECMO that showed an independent association with in-hospital mortality [adjusted HR, 1.06 (95 % CI, 1.03-1.10)].CONCLUSION: In this series of ARDS patients receiving ECMO for refractory hypoxemia, driving pressure during ECMO was the only ventilator setting that showed an independent association with in-hospital mortality.

AB - PURPOSE: Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for patients with acute respiratory distress syndrome (ARDS). The aim of this study was to evaluate associations between ventilatory settings during ECMO for refractory hypoxemia and outcome in ARDS patients.METHODS: In this individual patient data meta-analysis of observational studies in adult ARDS patients receiving ECMO for refractory hypoxemia, a time-dependent frailty model was used to determine which ventilator settings in the first 3 days of ECMO had an independent association with in-hospital mortality.RESULTS: Nine studies including 545 patients were included. Initiation of ECMO was accompanied by significant decreases in tidal volume size, positive end-expiratory pressure (PEEP), plateau pressure, and driving pressure (plateau pressure - PEEP) levels, and respiratory rate and minute ventilation, and resulted in higher PaO2/FiO2, higher arterial pH and lower PaCO2 levels. Higher age, male gender and lower body mass index were independently associated with mortality. Driving pressure was the only ventilatory parameter during ECMO that showed an independent association with in-hospital mortality [adjusted HR, 1.06 (95 % CI, 1.03-1.10)].CONCLUSION: In this series of ARDS patients receiving ECMO for refractory hypoxemia, driving pressure during ECMO was the only ventilator setting that showed an independent association with in-hospital mortality.

KW - Adult

KW - Age Factors

KW - Body Mass Index

KW - Extracorporeal Membrane Oxygenation/instrumentation

KW - Female

KW - Hospital Mortality

KW - Humans

KW - Hypoxia/therapy

KW - Male

KW - Middle Aged

KW - Observational Studies as Topic

KW - Positive-Pressure Respiration

KW - Respiration, Artificial/methods

KW - Respiratory Distress Syndrome/mortality

KW - Sex Factors

KW - Tidal Volume

KW - Time Factors

KW - Ventilators, Mechanical/standards

U2 - 10.1007/s00134-016-4507-0

DO - 10.1007/s00134-016-4507-0

M3 - SCORING: Journal article

C2 - 27586996

VL - 42

SP - 1672

EP - 1684

JO - INTENS CARE MED

JF - INTENS CARE MED

SN - 0342-4642

IS - 11

ER -