Association between ventilatory settings and development of acute respiratory distress syndrome in mechanically ventilated patients due to brain injury

VENTILA GROUP

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Purpose In neurologically critically ill patients with mechanical ventilation (MV), the development of acute respiratory distress syndrome (ARDS) is a major contributor to morbidity and mortality, but the role of ventilatory management has been scarcely evaluated. We evaluate the association of tidal volume, level of PEEP and driving pressure with the development of ARDS in a population of patients with brain injury. Materials and methods We performed a secondary analysis of a prospective, observational study on mechanical ventilation. Results We included 986 patients mechanically ventilated due to an acute brain injury (hemorrhagic stroke, ischemic stroke or brain trauma). Incidence of ARDS in this cohort was 3%. Multivariate analysis suggested that driving pressure could be associated with the development of ARDS (odds ratio for unit increment of driving pressure 1.12; confidence interval for 95%: 1.01 to 1.23) whereas we did not observe association for tidal volume (in ml per kg of predicted body weight) or level of PEEP. ARDS was associated with an increase in mortality, longer duration of mechanical ventilation, and longer ICU length of stay. Conclusions In a cohort of brain-injured patients the development of ARDS was not common. Driving pressure was associated with the development of this disease.

Original languageEnglish (US)
Pages (from-to)341-345
Number of pages5
JournalJournal of Critical Care
Volume38
DOIs
StatePublished - Apr 1 2017

Keywords

  • Acute respiratory distress syndrome
  • Driving pressure
  • Mechanical ventilation
  • Neurologic disease
  • Neurologically critically ill patients
  • Pulmonary complications

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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