Management and outcome of mechanically ventilated patients after cardiac arrest

Yuda Sutherasan, Oscar Penuelas, Alfonso Muriel, Maria Vargas, Fernando Frutos-Vivar, Iole Brunetti, Konstantinos Raymondos, Davide D'Antini, Niklas Nielsen, Niall Ferguson, Bernd W Bottiger, Arnaud W Thille, Andrew Ross Davies, Francisco Javier Hurtado, Fernando Rios, Carlos Apezteguia, Damian A Violi, Nahit Cakar, Marco Gonzalez, Bin DuMichael A Kuiper, Marco Antonio Soares, Younsuck Koh, Rui Paulo Moreno, Pravin Amin, Vinko Tomicic, Luis Soto, Hans-Henrik Bulow, Antonio Anzueto, Andres Esteban, Paolo Pelosi

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Abstract

Introduction: The aim of this study was to describe and compare the changes in ventilator management and complications over time, as well as variables associated with 28-day hospital mortality in patients receiving mechanical ventilation (MV) after cardiac arrest. Methods: We performed a secondary analysis of three prospective, observational multicenter studies conducted in 1998, 2004 and 2010 in 927 ICUs from 40 countries. We screened 18,302 patients receiving MV for more than 12 hours during a one-month-period. We included 812 patients receiving MV after cardiac arrest. We collected data on demographics, daily ventilator settings, complications during ventilation and outcomes. Multivariate logistic regression analysis was performed to calculate odds ratios, determining which variables within 24 hours of hospital admission were associated with 28-day hospital mortality and occurrence of acute respiratory distress syndrome (ARDS) and pneumonia acquired during ICU stay at 48 hours after admission. Results: Among 812 patients, 100 were included from 1998, 239 from 2004 and 473 from 2010. Ventilatory management changed over time, with decreased tidal volumes (VT) (1998: mean 8.9 (standard deviation (SD) 2) ml/kg actual body weight (ABW), 2010: 6.7 (SD 2) ml/kg ABW; 2004: 9 (SD 2.3) ml/kg predicted body weight (PBW), 2010: 7.95 (SD 1.7) ml/kg PBW) and increased positive end-expiratory pressure (PEEP) (1998: mean 3.5 (SD 3), 2010: 6.5 (SD 3); P
Original languageEnglish
Pages (from-to)1 - 11
Number of pages11
JournalCritical Care
Volume19
Issue number1 (Art. No: 215)
DOIs
Publication statusPublished - 2015

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