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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Airway pressure release ventilation versus assist-control ventilation: A comparative propensity score and international cohort study
Intensive Care Medicine, Volume 36, No. 5, Year 2010
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Description
Purpose: To compare characteristics and clinical outcomes of patients receiving airway pressure release ventilation (APRV) or biphasic positive airway pressure (BIPAP) to assist-control ventilation (A/C) as their primary mode of ventilatory support. The objective was to estimate if patients ventilated with APRV/BIPAP have a lower mortality. Methods: Secondary analysis of an observational study in 349 intensive care units from 23 countries. A total of 234 patients were included who were ventilated only with APRV/BIPAP and 1,228 patients who were ventilated only with A/C. A case-matched analysis according to a propensity score was used to make comparisons between groups. Results: In logistic regression analysis, the most important factor associated with the use of APRV/BIPAP was the country (196 of 234 patients were from German units). Patients with coma or congestive heart failure as the reason to start mechanical ventilation, pH <7.15 prior to mechanical ventilation, and patients who developed respiratory failure (SOFA score >2) after intubation with or without criteria of acute respiratory distress syndrome were less likely to be ventilated with APRV/BIPAP. In the case-matched analysis there were no differences in outcomes, including mortality in the intensive care unit, days of mechanical ventilation or weaning, rate of reintubation, length of stay in the intensive care unit or hospital, and mortality in the hospital. Conclusions: In this study, the APRV/BIPAP ventilation mode is being used widely across many causes of respiratory failure, but only in selected geographic areas. In our patient population we could not demonstrate any improvement in outcomes with APRV/BIPAP compared with assist-control ventilation. © 2010 Copyright jointly held by Springer and ESICM.
Authors & Co-Authors
González, Marco A.
Colombia, Medellin
Universidad Pontificia Bolivariana
Arróliga, Alejandro C.
United States, Temple
Scott and White
Frutos-Vivar, Fernando
Spain, Getafe
Hospital Universitario de Getafe
Spain, Madrid
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Raymondos, Konstantinos
Germany, Hannover
Hannover Medical School
Esteban, Andrés
Spain, Getafe
Hospital Universitario de Getafe
Spain, Madrid
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Putensen, Christian
Germany, Bonn
Universität Bonn
Apezteguía, Carlos J.
Argentina, Buenos Aires
Hospital Nacional Professor Dr. Alejandro Posadas
Hurtado, Javier L.
Uruguay, Montevideo
Hospital de Clinicas Dr. Manuel Quintela
Desmery, Pablo M.
Argentina, Buenos Aires
Sanatorio Mitre
Tomicic F, Vinko
Chile, Santiago
Clinica Alemana
Elizalde, José J.
Mexico
American British Cowdray Medical Center
Abrouk, Fekri
Tunisia, Monastir
Chu Fattouma-bourguiba
Arabi, Yaseen M.
Saudi Arabia, Riyadh
King Abdulaziz Medical City - Riyadh
Moreno, Rui Paulo
Portugal, Lisbon
Hospital de St. Antonio do Capuchos, Lisboa
Anzueto, Antonio R.
United States, San Antonio
University of Texas Health Science Center at San Antonio
Ferguson, Niall D.
Canada, Toronto
Mount Sinai Hospital of University of Toronto
Statistics
Citations: 76
Authors: 16
Affiliations: 16
Identifiers
Doi:
10.1007/s00134-010-1837-1
ISSN:
03424642
e-ISSN:
14321238
Research Areas
Health System And Policy
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative