Reference : Epidemiology and outcome of acute lung injury in European intensive care units. Resul...
Scientific journals : Article
Human health sciences : Anesthesia & intensive care
http://hdl.handle.net/2268/37027
Epidemiology and outcome of acute lung injury in European intensive care units. Results from the ALIVE study
English
Brun-Buisson, Christian [ > > ]
Minelli, Cosetta [ > > ]
Bertolini, Guido [ > > ]
Brazzi, Luca [ > > ]
Pimentel, Jorge [ > > ]
Lewandowski, Klaus [ > > ]
Bion, Julian [ > > ]
Romand, Jacques-André [ > > ]
Villar, Jesús [ > > ]
Thorsteinsson, Adalbjörn [ > > ]
Damas, Pierre mailto [Université de Liège - ULiège > > Soins intensifs >]
Armaganidis, Apostol [ > > ]
Lemaire, François [ > > ]
2004
Intensive Care Medicine
Springer Verlag
30
1
51-61
Yes (verified by ORBi)
International
0342-4642
New York
NY
[en] Epidemiology ; Acute lung injury ; Acute respiratory distress syndrome ; Mechanical ventilation ; Positive pressure ventilation ; Barotrauma
[en] Abstract Objectives: To re-examine the epidemiology of acute lung injury (ALI) in European intensive care units (ICUs). Design and setting: A 2-month inception cohort study in 78 ICUs of 10 European countries. Patients: All patients admitted for more than 4 h were screened for ALI
and followed up to 2 months. Measurements and main results: Acute lung injury occurred in 463
(7.1%) of 6,522 admissions and 16.1% of all mechanically ventilated patients; 65.4% cases occurred on ICU admission. Among 136 patients initially presenting with “mild ALI”
(200< PaO2/FiO2 £300), 74 (55%) evolved to acute respiratory distress syndrome (ARDS) within 3 days. Sixty-two patients (13.4%) remained with mild ALI and 401 had ARDS. The crude ICU and hospital mortalities were 22.6% and 32.7% (p<0.001), and 49.4% and 57.9% (p=0.0005), respectively, for mild ALI and ARDS. ARDS patients initially received a mean tidal volume
of 8.3±1.9 ml/kg and a mean PEEP of 7.7±3.6 cmH2O; air leaks occurred in 15.9%. After multivariate analysis, mortality was associated with age (odds ratio (OR) =1.2 per 10 years; 95% confidence interval (CI): 1.05–1.36), immuno-incompetence (OR: 2.88; Cl: 1.57–5.28), the
severity scores SAPS II (OR: 1.16 per 10% expected mortality; Cl: 1.02–1.31) and logistic organ dysfunction (OR: 1.25 per point; Cl: 1.13–1.37), a pH less than 7.30 (OR: 1.88; Cl: 1.11–3.18) and early air leak (OR: 3.16; Cl: 1.59–6.28). Conclusions: Acute lung injury was frequent in our sample of European ICUs (7.1%); one third of patients presented with mild ALI, but more
than half rapidly evolved to ARDS. While the mortality of ARDS remains high, that of mild ALI is twice as low, confirming the grading of severity between the two forms of the syndrome.
Researchers ; Professionals
http://hdl.handle.net/2268/37027
10.1007/s00134-003-2022-6

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