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Management and outcome of mechanically ventilated patients after cardiac arrest Critical Care Sample (2015) 19:215 doi:10.1186/s13054-015-0922-9 Yuda Sutherasan ([email protected]) Oscar Peñuelas ([email protected]) Alfonso Muriel ([email protected]) Maria Vargas ([email protected]) Fernando Frutos-Vivar ([email protected]) Iole Brunetti ([email protected]) Konstantinos Raymondos ([email protected]) Davide D’Antini ([email protected]) Niklas Nielsen ([email protected]) Niall D Ferguson ([email protected]) Bernd W Böttiger ([email protected]) Arnaud W Thille ([email protected]) Andrew R Davies ([email protected]) Javier Hurtado ([email protected]) Fernando Rios ([email protected]) Carlos Apezteguía ([email protected]) Damian A Violi ([email protected]) Nahit Cakar ([email protected]) Marco González ([email protected]) Bin Du ([email protected]) Michael A Kuiper ([email protected]) Marco Antonio Soares ([email protected]) Younsuck Koh ([email protected]) Rui P Moreno ([email protected]) Pravin Amin ([email protected]) Vinko Tomicic ([email protected]) Luis Soto ([email protected]) Hans-Henrik Bülow ([email protected]) Antonio Anzueto ([email protected]) Andrés Esteban ([email protected]) Paolo Pelosi ([email protected]) For the VENTILA GROUP Sample

ISSN Article type

1364-8535 Research

Submission date

4 February 2015

Acceptance date

13 April 2015

Article URL

http://dx.doi.org/10.1186/s13054-015-0922-9

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© 2015 Sutherasan et al. ; licensee BioMed Central This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Management and outcome of mechanically ventilated patients after cardiac arrest Yuda Sutherasan1,2 Email: [email protected] Oscar Peñuelas3 Email: [email protected] Alfonso Muriel4 Email: [email protected] Maria Vargas5 Email: [email protected] Fernando Frutos-Vivar6 Email: [email protected] Iole Brunetti2 Email: [email protected] Konstantinos Raymondos7 Email: [email protected] Davide D’Antini8 Email: [email protected] Niklas Nielsen9 Email: [email protected] Niall D Ferguson10 Email: [email protected] Bernd W Böttiger11 Email: [email protected] Arnaud W Thille12 Email: [email protected] Andrew R Davies13 Email: [email protected] Javier Hurtado14 Email: [email protected] Fernando Rios15 Email: [email protected]

Carlos Apezteguía15 Email: [email protected] Damian A Violi16 Email: [email protected] Nahit Cakar17 Email: [email protected] Marco González18 Email: [email protected] Bin Du19 Email: [email protected] Michael A Kuiper20 Email: [email protected] Marco Antonio Soares21 Email: [email protected] Younsuck Koh22 Email: [email protected] Rui P Moreno23 Email: [email protected] Pravin Amin24 Email: [email protected] Vinko Tomicic25 Email: [email protected] Luis Soto26 Email: [email protected] Hans-Henrik Bülow27 Email: [email protected] Antonio Anzueto28 Email: [email protected] Andrés Esteban6 Email: [email protected] Paolo Pelosi2* * Corresponding author Email: [email protected] For the VENTILA GROUP

1

Ramathibodi hospital, Mahidol University, Bangkok, Thailand

2

Department of Surgical Sciences and Integrated Diagnostics IRCCS AOU San Martino-IST, Largo Rosanna Benzi 8, Genoa 16131, Italy

3

Critical Care Department, Hospital Universitario de Getafe, Madrid, Spain

4

Biostatistics Unit, Ramón y Cajal Hospital Ramón y Cajal Institute and Research Health, IRYCIS, CIBERESP, Madrid, Spain

5

Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples “Federico II, Naples, Italy

6

Hospital Universitario de Getafe and CIBER Enfermedades Respiratorias, Madrid, Spain

7

Anaesthesiology and Intensive Care Medicine, Medical School Hanover, CarlNeuberg-Strasse 1, D-30625 Hanover, Germany

8

Dipartimento di Anestesia, Rianimazione e Terapia Intensiva, Universita’ degli Studi di Foggia, Foggia, Italy

9

Department of Anesthesia and Intensive Care, Intensive Care Unit, Helsingborg Hospital, S Vallgatan 5, 251 87 Helsingborg, Sweden

10

Interdepartmental Division of Critical Care Medicine, Department of Medicine, University of Toronto, University Health Network and Mount Sinai Hospital, Toronto, ON, Canada

11

Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Straße 62, 50937 Köln, Germany

12

Cenre Hospitalier Universitaire de Poitiers, Réanimation Médicale, INSERM CIC 1402, Université de Poitiers, Poitiers, France

13

ANZIC-RC, Monash University, Melbourne, Australia

14

Hospital de Clínicas de Montevideo, Montevideo, Uruguay

15

Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina

16

Hospital Interzonal General de Agudos Dr. Luis Güemes, Haedo, Argentina

17

Istanbul Medical Faculty, Anesthesiology and Intensive Care, Capa/Istanbul, Istanbul, Turkey 18

Clínica Medellín & Universidad Pontificia Bolivariana, Medellín, Colombia

19

Peking Union Medical College Hospital, Beijing, People’s Republic of China

20

Medical Center Leeuwarden, Leeuwarden, The Netherlands

21

Hospital Universitário São José, Belo Horizonte, Brazil

22

Asan Medical Center, University of Ulsan, Seoul, Republic of Korea

23

Unidade de Cuidados Intensivos Polivalente, Hospital de São José, Centro Hospitalar, de Lisboa Central, Rua José António Serrano, 1150-199 Lisbon, Portugal

24

Bombay Hospital Institute of Medical Sciences, Mumbai, India

25

Clínica Las Lilas de Santiago, Santiago, Chile

26

Instituto Nacional del Tórax de Santiago, Santiago, Chile

27

Holbaek Hospital, Region Zealand University of Copenhagen, Copenhagen, Denmark

28

South Texas Veterans Health Care System and University of Texas Health Science Center, San Antonio, Texas

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 Secondary analysis of three prospective, observational multicenter studies conducted in 1998, 2004 and 2010 in 927 intensive care units (ICUs) from 40 countries. We screened 18,302 patients receiving MV for longer than 12 hours during a one-month period. We included 812 patients receiving MV after cardiac arrest. We collected demographics, daily ventilator settings, complications during ventilation and outcomes. Multivariate logistic regression analysis was performed to calculate odds ratios determining that which variables within 24 hours of hospital admission were associated with 28-day hospital mortality and the occurrence of 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) [from a mean 8.9 (standard deviation 2) ml/kg actual body weight (ABW) in 1998 to 6.7(2) ml/kg ABW in 2010 and from 9(2.3) ml/kg predicted body weight (PBW) in 2004 to 7.95(1.7) ml/kg PBW in 2010] and increased positive end-expiratory pressure (PEEP) [from 3.5(3) in 1998 to 6.5(3) in 2010] (p