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Archivio istituzionale della ricerca dell'Università degli Studi di Palermo
BACKGROUND:
Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study.
METHODS:
In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia).
RESULTS:
Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47).
CONCLUSIONS:
Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort.
Madotto F, R.E., LUNG SAFE Investigators and the ESICM Trials Group, S.M.B. (2020). Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome: insights from the LUNG SAFE study. CRITICAL CARE, 24(1), 1-17 [10.1186/s13054-020-2826-6].
Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome: insights from the LUNG SAFE study
Madotto F;Rezoagli E;Pham T;Schmidt M;McNicholas B;Protti A;Panwar R;Bellani G;Fan E;van Haren F;Brochard L;Laffey JG;Antonio Pesenti;John G Laffey;Laurent Brochard;Andres Esteban;Luciano Gattinoni;Frank van Haren;Anders Larsson;Daniel F McAuley;Marco Ranieri;Gordon Rubenfeld;B Taylor Thompson;Hermann Wrigge;Arthur S Slutsky;Fernando Rios;T Sottiaux;P Depuydt;Fredy S Lora;Luciano Cesar Azevedo;Eddy Fan;Guillermo Bugedo;Haibo Qiu;Marcos Gonzalez;Juan Silesky;Vladimir Cerny;Jonas Nielsen;Manuel Jibaja;Tài Pham;Dimitrios Matamis;Jorge Luis Ranero;Pravin Amin;S M Hashemian;Kevin Clarkson;Giacomo Bellani;Kiyoyasu Kurahashi;Asisclo Villagomez;Amine Ali Zeggwagh;Leo M Heunks;Jon Henrik Laake;Jose Emmanuel Palo;Antero do Vale Fernandes;Dorel Sandesc;Yaasen Arabi;Vesna Bumbasierevic;Nicolas Nin;Jose A Lorente;Lise Piquilloud;Fekri Abroug;Daniel F McAuley;Lia McNamee;Javier Hurtado;Ed Bajwa;Gabriel Démpaire;Uhc Mother Theresa;Hektor Sula;Lordian Nunci;Alma Cani;Villa Maria;Alan Zazu;Christian Dellera;Carolina S Insaurralde;Risso V Alejandro;Julio Daldin;Mauricio Vinzio;Ruben O Fernandez;Luis P Cardonnet;Lisandro R Bettini;Mariano Carboni Bisso;Emilio M Osman;Mariano G Setten;Pablo Lovazzano;Javier Alvarez;Veronica Villar;Norberto C Pozo;Nicolas Grubissich;Gustavo A Plotnikow;Daniela N Vasquez;Santiago Ilutovich;Norberto Tiribelli;Ariel Chena;Carlos A Pellegrini;María G Saenz;Elisa Estenssoro;Matias Brizuela;Hernan Gianinetto;Pablo E Gomez;Valeria I Cerrato;Marco G Bezzi;Silvina A Borello;Flavia A Loiacono;Adriana M Fernandez;Serena Knowles;Claire Reynolds;Deborah M Inskip;Jennene J Miller;Jing Kong;Christina Whitehead;Shailesh Bihari;Aylin Seven;Amanda Krstevski;Helen J Rodgers;Rebecca T Millar;Toni E Mckenna;Irene M Bailey;Gabrielle C Hanlon;Anders Aneman;Joan M Lynch;Raman Azad;John Neal;Paul W Woods;Brigit L Roberts;Mark R Kol;Helen S Wong;Katharina C Riss;Thomas Staudinger;Xavier Wittebole;Caroline Berghe;Pierre A Bulpa;Alain M Dive;Rik Verstraete;Herve Lebbinck;Pieter Depuydt;Joris Vermassen;Philippe Meersseman;Helga Ceunen;Jonas I Rosa;Daniel O Beraldo;Claudio Piras;Adenilton M Rampinelli;Antonio P Nassar Jr;Sergio Mataloun;Marcelo Moock;Marlus M Thompson;Claudio H Gonçalves;Ana Carolina P Antônio;Aline Ascoli;Rodrigo S Biondi;Danielle C Fontenele;Danielle Nobrega;Vanessa M Sales;Suresh Shindhe;Dk Maizatul Aiman B Pg Hj Ismail;John Laffey;Francois Beloncle;Kyle G Davies;Rob Cirone;Venika Manoharan;Mehvish Ismail;Ewan C Goligher;Mandeep Jassal;Erin Nishikawa;Areej Javeed;Gerard Curley;Nuttapol Rittayamai;Matteo Parotto;Niall D Ferguson;Sangeeta Mehta;Jenny Knoll;Antoine Pronovost;Sergio Canestrini;Alejandro R Bruhn;Patricio H Garcia;Felipe A Aliaga;Pamela A Farías;Jacob S Yumha;Claudia A Ortiz;Javier E Salas;Alejandro A Saez;Luis D Vega;Eduardo F Labarca;Felipe T Martinez;Nicolás G Carreño;Pilar Lora;Haitao Liu;Ling Liu;Rui Tang;Xiaoming Luo;Youzhong An;Huiying Zhao;Yan Gao;Zhe Zhai;Zheng L Ye;Wei Wang;Wenwen Li;Qingdong Li;Ruiqiang Zheng;Wenkui Yu;Juanhong Shen;Xinyu Li;Tao Yu;Weihua Lu;Ya Q Wu;Xiao B Huang;Zhenyang He;Yuanhua Lu;Hui Han;Fan Zhang;Renhua Sun;Hua X Wang;Shu H Qin;Bao H Zhu;Jun Zhao;Jian Liu;Bin Li;Jing L Liu;Fa C Zhou;Qiong J Li;Xing Y Zhang;Zhou Li-Xin;Qiang Xin-Hua;Liangyan Jiang;Yuan N Gao;Xian Y Zhao;Yuan Y Li;Xiao L Li;Chunting Wang;Qingchun Yao;Rongguo Yu;Kai Chen;Huanzhang Shao;Bingyu Qin;Qing Q Huang;Wei H Zhu;Ai Y Hang;Ma X Hua;Yimin Li;Yonghao Xu;Yu D Di;Long L Ling;Tie H Qin;Shou H Wang;Junping Qin;Yi Han;Suming Zhou;Monica P Vargas;Juan I Silesky Jimenez;Manuel A González Rojas;Jaime E Solis-Quesada;Christian M Ramirez-Alfaro;Jan Máca;Peter Sklienka;Jakob Gjedsted;Aage Christiansen;Boris G Villamagua;Miguel Llano;Philippe Burtin;Gautier Buzancais;Pascal Beuret;Nicolas Pelletier;Satar Mortaza;Alain Mercat;Jonathan Chelly;Sébastien Jochmans;Nicolas Terzi;Cédric Daubin;Guillaume Carteaux;Nicolas de Prost;Jean-Daniel Chiche;Fabrice Daviaud;Tai Pham;Muriel Fartoukh;Guillaume Barberet;Jerome Biehler;Jean Dellamonica;Denis Doyen;Jean-Michel Arnal;Anais Briquet;Sami Hraiech;Laurent Papazian;Arnaud Follin;Damien Roux;Jonathan Messika;Evangelos Kalaitzis;Laurence Dangers;Alain Combes;Siu-Ming Au;Gaetan Béduneau;Dorothée Carpentier;Elie H Zogheib;Herve Dupont;Sylvie Ricome;Francesco L Santoli;Sebastien L Besset;Philippe Michel;Bruno Gelée;Pierre-Eric Danin;Bernard Goubaux;Philippe J Crova;Nga T Phan;Frantz Berkelmans;Julio C Badie;Romain Tapponnier;Josette Gally;Samy Khebbeb;Jean-Etienne Herbrecht;Francis Schneider;Pierre-Louis M Declercq;Jean-Philippe Rigaud;Jacques Duranteau;Anatole Harrois;Russell Chabanne;Julien Marin;Charlene Bigot;Sandrine Thibault;Mohammed Ghazi;Messabi Boukhazna;Salem Ould Zein;Jack R Richecoeur;Daniele M Combaux;Fabien Grelon;Charlene Le Moal;Elise P Sauvadet;Adrien Robine;Virginie Lemiale;Danielle Reuter;Martin Dres;Alexandre Demoule;Dany Goldgran-Toledano;Loredana Baboi;Claude Guérin;Ralph Lohner;Jens Kraßler;Susanne Schäfer;Kai D Zacharowski;Patrick Meybohm;Andreas W Reske;Philipp Simon;Hans-Bernd F Hopf;Michael Schuetz;Thomas Baltus;Metaxia N Papanikolaou;Theonymfi G Papavasilopoulou;Giannis A Zacharas;Vasilis Ourailogloy;Eleni K Mouloudi;Eleni V Massa;Eva O Nagy;Electra E Stamou;Ellada V Kiourtzieva;Marina A Oikonomou;Luis E Avila;Cesar A Cortez;Johanna E Citalán;Sameer A Jog;Safal D Sable;Bhagyesh Shah;Mohan Gurjar;Arvind K Baronia;Mohammedfaruk Memon;Radhakrishnan Muthuchellappan;Venkatapura J Ramesh;Anitha Shenoy;Ramesh Unnikrishnan;Subhal B Dixit;Rachana V Rhayakar;Nagarajan Ramakrishnan;Vallish K Bhardwaj;Heera L Mahto;Sudha V Sagar;Vijayanand Palaniswamy;Deeban Ganesan;Seyed Mohammadreza Hashemian;Hamidreza Jamaati;Farshad Heidari;Edel A Meaney;Alistair Nichol;Karl M Knapman;Donall O'Croinin;Eimhin S Dunne;Dorothy M Breen;Kevin P Clarkson;Rola F Jaafar;Rory Dwyer;Fahd Amir;Olaitan O Ajetunmobi;Aogan C O'Muircheartaigh;Colin S Black;Nuala Treanor;Daniel V Collins;Wahid Altaf;Gianluca Zani;Maurizio Fusari;Savino Spadaro;Carlo A Volta;Romano Graziani;Barbara Brunettini;Salvatore Palmese;Paolo Formenti;Michele Umbrello;Andrea Lombardo;Elisabetta Pecci;Marco Botteri;Monica Savioli;Alessandro Protti;Alessia Mattei;Lorenzo Schiavoni;Andrea Tinnirello;Manuel Todeschini;Antonino Giarratano;Andrea Cortegiani;Sara Sher;Anna Rossi;Massimo M Antonelli;Luca M Montini;Paolo Casalena;Sergio Scafetti;Giovanna Panarello;Giovanna Occhipinti;Nicolò Patroniti;Matteo Pozzi;Roberto R Biscione;Michela M Poli;Ferdinando Raimondi;Daniela Albiero;Giulia Crapelli;Eduardo Beck;Vincenzo Pota;Vincenzo Schiavone;Alexandre Molin;Fabio Tarantino;Giacomo Monti;Elena Frati;Lucia Mirabella;Gilda Cinnella;Tommaso Fossali;Riccardo Colombo;Pierpaolo Terragni Ilaria Pattarino;Francesco Mojoli;Antonio Braschi;Erika E Borotto;Andrea N Cracchiolo;Daniela M Palma;Francesco Raponi;Giuseppe Foti;Ettore R Vascotto;Andrea Coppadoro;Luca Brazzi;Leda Floris;Giorgio A Iotti;Aaron Venti;Osamu Yamaguchi;Shunsuke Takagi;Hiroki N Maeyama;Eizo Watanabe;Yoshihiro Yamaji;Kazuyoshi Shimizu;Kyoko Shiozaki;Satoru Futami;Sekine Ryosuke;Koji Saito;Yoshinobu Kameyama;Keiko Ueno;Masayo Izawa;Nao Okuda;Hiroyuki Suzuki;Tomofumi Harasawa;Michitaka Nasu;Tadaaki Takada;Fumihito Ito;Shin-Nunomiya Kansuke-Koyama;Toshikazu Abe;Kohkichi Andoh;Kohei Kusumoto;Akira Hirata;Akihiro Takaba;Hiroyasu Kimura;Shuhei Matsumoto;Ushio Higashijima;Hiroyuki Honda;Nobumasa Aoki;Hiroshi Imai;Yasuaki Ogino;Ichiko Mizuguchi;Kazuya Ichikado;Kenichi Nitta;Katsunori Mochizuki;Tomoaki Hashida;Hiroyuki Tanaka;Tomoyuki Nakamura;Daisuke Niimi;Takeshi Ueda;Yozo Kashiwa;Akinori Uchiyama;Olegs Sabelnikovs;Peteris Oss;Youssef Haddad;Kong Y Liew;Silvio A Ñamendys-Silva;Yves D Jarquin-Badiola;Luis A Sanchez-Hurtado;Saira S Gomez-Flores;Maria C Marin;Asisclo J Villagomez;Jordana S Lemus;Jonathan M Fierro;Mavy Ramirez Cervantes;Francisco Javier Flores Mejia;Dulce Dector;Dulce M Dector;Daniel R Gonzalez;Claudia R Estrella;Jorge R Sanchez-Medina;Alvaro Ramirez-Gutierrez;Fernando G George;Janet S Aguirre;Juan A Buensuseso;Manuel Poblano;Tarek Dendane;Hicham Balkhi;Mina Elkhayari;Nacer Samkaoui;Hanane Ezzouine;Abdellatif Benslama Mourad Amor;Wajdi Maazouzi;Nedim Cimic;Oliver Beck;Monique M Bruns;Jeroen A Schouten;Myra-Rinia;Monique Raaijmakers;Hellen M Van Wezel;Serge J Heines;Ulrich Strauch;Marc P Buise;Fabienne D Simonis;Marcus J Schultz;Jennifer C Goodson;Troy S Browne;Leanlove Navarra;Anna Hunt;Robyn A Hutchison;Mathew B Bailey;Lynette Newby;Colin Mcarthur;Michael Kalkoff;Alex Mcleod;Jonathan Casement;Danielle J Hacking;Finn H Andersen;Merete S Dolva;Jon H Laake;Andreas Barratt-Due;Kim Andre L Noremark;Eldar Søreide;Brit Å Sjøbø;Anne B Guttormsen;Hector H Leon Yoshido;Ronald Zumaran Aguilar;Fredy A Montes Oscanoa;Alain U Alisasis;Joanne B Robles;Rossini Abbie B Pasanting-Lim;Beatriz C Tan;Pawel Andruszkiewicz;Karina Jakubowska;Cristina M Coxo;António M Alvarez;Bruno S Oliveira;Gustavo M Montanha;Nelson C Barros;Carlos S Pereira;António M Messias;Jorge M Monteiro;Ana M Araujo;Nuno T Catorze;Susan M Marum;Maria J Bouw;Rui M Gomes;Vania A Brito;Silvia Castro;Joana M Estilita;Filipa M Barros;Isabel M Serra;Aurelia M Martinho;Dana R Tomescu;Alexandra Marcu;Ovidiu H Bedreag;Marius Papurica;Dan E Corneci;Silvius Ioan Negoita;Evgeny Grigoriev;Alexey I Gritsan;Andrey A Gazenkampf;Ghaleb Almekhlafi;Mohamad M Albarrak;Ghanem M Mustafa;Khalid A Maghrabi;Nawal Salahuddin;Tharwat M Aisa;Ahmed S Al Jabbary;Edgardo Tabhan;Yaseen M Arabi;Olivia A Trinidad;Hasan M Al Dorzi;Edgardo E Tabhan;Stefan Bolon;Oliver Smith;Jordi Mancebo;Hernan Aguirre-Bermeo;Juan C Lopez-Delgado;Francisco Esteve;Gemma Rialp;Catalina Forteza;Candelaria De Haro;Antonio Artigas;Guillermo M Albaiceta;Sara De Cima-Iglesias;Leticia Seoane-Quiroga;Alexandra Ceniceros-Barros;Antonio L Ruiz-Aguilar;Luis M Claraco-Vega;Juan Alfonso Soler;Maria Del Carmen Lorente;Cecilia Hermosa;Federico Gordo;Miryam-Prieto-González;Juan B López-Messa;Manuel P Perez;Cesar P Perez;Raquel Montoiro Allue;Ferran Roche-Campo;Marcos Ibañez-Santacruz;Susana-Temprano;Maria C Pintado;Raul De Pablo;Pilar Ricart Aroa Gómez;Silvia Rodriguez Ruiz;Silvia Iglesias Moles;Mª Teresa Jurado;Alfons Arizmendi;Enrique A Piacentini;Nieves Franco;Teresa Honrubia;Meisy Perez Cheng;Elena Perez Losada;Javier-Blanco;Luis J Yuste;Cecilia Carbayo-Gorriz;Francisca G Cazorla-Barranquero;Javier G Alonso;Rosa S Alda;Ángela Algaba;Gonzalo Navarro;Enrique Cereijo;Esther Diaz-Rodriguez;Diego Pastor Marcos;Laura Alvarez Montero;Luis Herrera Para;Roberto Jimenez Sanchez;Miguel Angel Blasco Navalpotro;Ricardo Diaz Abad;Raquel Montiel Gonz Á Lez;D Á Cil Parrilla Toribio;Alejandro G Castro;Maria Jose D Artiga;Oscar Penuelas;Tomas P Roser;Moreno F Olga;Elena Gallego Curto;Rocío Manzano Sánchez;Vallverdu P Imma;Garcia M Elisabet;Laura Claverias;Monica Magret;Ana M Pellicer;Lucia L Rodriguez;Jesús Sánchez-Ballesteros;Ángela González-Salamanca;Antonio G Jimenez;Francisco P Huerta;Juan Carlos J Sotillo Diaz;Esther Bermejo Lopez;David D Llinares Moya;Alec A Tallet Alfonso;Palazon Sanchez Eugenio Luis;Palazon Sanchez Cesar;Sánchez I Rafael;Corcoles G Virgilio;Noelia N Recio;Richard O Adamsson;Christian C Rylander;Bernhard Holzgraefe;Lars M Broman;Joanna Wessbergh;Linnea Persson;Fredrik Schiöler;Hans Kedelv;Anna Oscarsson Tibblin;Henrik Appelberg;Lars Hedlund;Johan Helleberg;Karin E Eriksson;Rita Glietsch;Niklas Larsson;Ingela Nygren;Silvia L Nunes;Anna-Karin Morin;Thomas Kander;Anne Adolfsson;Hervé O Zender;Corinne Leemann-Refondini;Souheil Elatrous;Slaheddine Bouchoucha;Imed Chouchene;Islem Ouanes;Asma Ben Souissi;Salma Kamoun;Oktay Demirkiran;Mustafa Aker;Emre Erbabacan;Ilkay Ceylan;Nermin Kelebek Girgin;Menekse Ozcelik;Necmettin Ünal;Basak Ceyda Meco;Onat O Akyol;Suleyman S Derman;Barry Kennedy;Ken Parhar;Latha Srinivasa;Danny McAuley;Phil Hopkins;Clare Mellis;Vivek Kakar;Dan Hadfield;Andre Vercueil;Kaushik Bhowmick;Sally K Humphreys;Andrew Ferguson;Raymond Mckee;Ashok S Raj;Danielle A Fawkes;Philip Watt;Linda Twohey;Rajeev R JhaMatthew Thomas;Alex Morton;Varsha Kadaba;Mark J Smith;Anil P Hormis;Santhana G Kannan;Miriam Namih;Henrik Reschreiter;Julie Camsooksai;Alek Kumar;Szabolcs Rugonfalvi;Christopher Nutt;Orla O'Neill;Colette Seasman;Ged Dempsey;Christopher J Scott;Helen E Ellis;Stuart Mckechnie;Paula J Hutton;Nora N Di Tomasso;Michela N Vitale;Ruth O Griffin;Michael N Dean;Julius H Cranshaw;Emma L Willett;Nicholas Ioannou;Sarah Gillis;Peter Csabi;Rosaleen Macfadyen;Heidi Dawson;Pieter D Preez;Alexandra J Williams;Owen Boyd;Laura Ortiz-Ruiz De Gordoa;Jon Bramall;Sophie Symmonds;Simon K Chau;Tim Wenham;Tamas Szakmany;Piroska Toth-Tarsoly;Katie H McCalman;Peter Alexander;Lorraine Stephenson;Thomas Collyer;Rhiannon Chapman;Raphael Cooper;Russell M Allan;Malcolm Sim;David W Wrathall;Donald A Irvine;Kim S Zantua;John C Adams;Andrew J Burtenshaw;Gareth P Sellors;Ingeborg D Welters;Karen E Williams;Robert J Hessell;Matthew G Oldroyd;Ceri E Battle;Suresh Pillai;Istvan Kajtor;Mageswaran Sivashanmugavel;Sinead C O'Kane;Adrian Donnelly;Aniko D Frigyik;Jon P Careless;Martin M May;Richard Stewart;T John Trinder;Samantha J Hagan;Matt P Wise;Jade M Cole;Caroline C MacFie;Anna T Dowling;Nicolás Nin;Edgardo Nuñez;Gustavo Pittini;Ruben Rodriguez;María C Imperio;Cristina Santos;Ana G França;Alejandro Ebeid;Alberto Deicas;Carolina Serra;Aditya Uppalapati;Ghassan Kamel;Valerie M Banner-Goodspeed;Jeremy R Beitler;Satyanarayana Reddy Mukkera;Shreedhar Kulkarni;Jarone Lee;Tomaz Mesar;John O Shinn 3rd;Dina Gomaa;Christopher Tainter;Dale J Yeatts;Jessica Warren;Michael J Lanspa;Russel R Miller;Colin K Grissom;Madotto F;Rezoagli E;Pham T;Schmidt M;McNicholas B;Protti A;Panwar R;Bellani G;Fan E;van Haren F;Brochard L;Laffey JG;LUNG SAFE Investigators and the ESICM Trials Group;Samuel M Brown;Philippe R Bauer;Ryan J Gosselin;Barrett T Kitch;Jason E Cohen;Scott H Beegle;Renaud M Gueret;Aiman Tulaimat;Shazia Choudry;William Stigler;Hitesh Batra;Nidhi G Huff;Keith D Lamb;Trevor W Oetting;Nicholas M Mohr;Claine Judy;Shigeki Saito;Fayez M Kheir;Fayez Kheir;Adam B Schlichting;Angela Delsing;Daniel R Crouch;Mary Elmasri;Dina Ismail;Kyle R Dreyer;Thomas C Blakeman;Rebecca M Baron;Carolina Quintana Grijalba;Peter C Hou;Raghu Seethala;Imo Aisiku;Galen Henderson;Gyorgy Frendl;Sen-Kuang Hou;Robert L Owens;Ashley Schomer;Vesna Bumbasirevic;Bojan Jovanovic;Maja Surbatovic;Milic Veljovic
2020-01-01
Abstract
BACKGROUND:
Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study.
METHODS:
In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia).
RESULTS:
Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47).
CONCLUSIONS:
Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort.
Madotto F, R.E., LUNG SAFE Investigators and the ESICM Trials Group, S.M.B. (2020). Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome: insights from the LUNG SAFE study. CRITICAL CARE, 24(1), 1-17 [10.1186/s13054-020-2826-6].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/406498
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.