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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Immunocompromised patients with acute respiratory distress syndrome: Secondary analysis of the LUNG SAFE database
Critical Care, Volume 22, No. 1, Article 157, Year 2018
Notification
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Description
Background: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p < 0.0001), despite similar severity of ARDS. Decisions regarding limiting life-sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p < 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013. © 2018 The Author(s).
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Authors & Co-Authors
Cortegiani, Andrea
Italy, Palermo
Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone
Madotto, Fabiana
Italy, Milan
Università Degli Studi Di Milano-bicocca
Gregóretti, Cesare
Italy, Palermo
Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone
Bellani, Giacomo
Italy, Milan
Università Degli Studi Di Milano-bicocca
Italy, Monza
Azienda Ospedaliera San Gerardo Monza
Laffey, John
Ireland, Galway
University of Galway
Canada, Toronto
University of Toronto
Canada, Toronto
Li ka Shing Knowledge Institute
Canada, Toronto
Saint Michael's Hospital University of Toronto
Pham, Tài I.
Canada, Toronto
University of Toronto
Canada, Toronto
Li ka Shing Knowledge Institute
France, Paris
Hôpital Tenon
van Haren, Frank M.P.
Australia, Canberra
The Australian National University
Australia, Canberra
Canberra Hospital
Antonelli, Massimo M.
Italy, Rome
Fondazione Policlinico Universitario Agostino Gemelli Irccs
Pesenti, Antonio Maria
Italy, Milan
Fondazione Irccs Ca' Granda Ospedale Maggiore Policlinico
Italy, Milan
Università Degli Studi Di Milano
Grasselli, Giacomo
Italy, Milan
Fondazione Irccs Ca' Granda Ospedale Maggiore Policlinico
Sula, Hektor H.
Unknown Affiliation
Nunci, Lordian
Unknown Affiliation
Cani, Alma
Albania, Tirana
University Hospital Centre Tirana
Zazu, Alan
Unknown Affiliation
Dellera, Christian
Unknown Affiliation
Insaurralde, Carolina S.
Unknown Affiliation
Alejandro, Risso V.
Unknown Affiliation
Daldin, Julio
Unknown Affiliation
Vinzio, Mauricio
Unknown Affiliation
Fernández, Rubén Oscar
Unknown Affiliation
Cardonnet, Luis Pablo
Unknown Affiliation
Bettini, Lisandro Roberto
Unknown Affiliation
Bisso, Mariano Carboni
Unknown Affiliation
Osman, Emilio M.
Unknown Affiliation
Setten, Mariano G.
Unknown Affiliation
Lovazzano, Pablo
Unknown Affiliation
Álvarez, Javier Abades Vila
Unknown Affiliation
Villar, Veronica
Unknown Affiliation
Pozo, Norberto Christian
Unknown Affiliation
Grubissich, Nicolas
Unknown Affiliation
Plotnikow, Gustavo Adrián
Unknown Affiliation
Vásquez, Daniela Noris
Unknown Affiliation
Ilutovich, Santiago
Unknown Affiliation
Tiribelli, Norberto
Unknown Affiliation
Chena, Ariel
Unknown Affiliation
Pellegrini, Carlos Anibal
Unknown Affiliation
Saenz, María Gabriela
Unknown Affiliation
Estenssoro, Elisa
Unknown Affiliation
Brizuela, Matías
Unknown Affiliation
Gianinetto, Hernan
Unknown Affiliation
Gómez, Pablo Edgardo
Unknown Affiliation
Cerrato, Valeria I.
Unknown Affiliation
Bezzi, Marco Guillermo
Unknown Affiliation
Borello, Silvina A.
Unknown Affiliation
Loiacono, Flavia A.
Unknown Affiliation
Fernandez, Adriana M.
Unknown Affiliation
Knowles, Serena
Australia, Sydney
St. Vincent's Hospital Sydney
Reynolds, Claire
Australia, Sydney
St. Vincent's Hospital Sydney
Inskip, Deborah M.
Australia, Sydney
St George Hospital
Miller, Jennene J.
Australia, Sydney
St George Hospital
Kong, Jing
Australia, Sydney
Westmead Hospital
Whitehead, Christina
Australia, Sydney
Westmead Hospital
Bihari, Shailesh
Australia, Adelaide
Flinders Medical Centre
Seven, Aylin
Australia, Newcastle
John Hunter Hospital
Krstevski, Amanda
Australia, Newcastle
John Hunter Hospital
Rodgers, Helen J.
Australia, Canberra
Canberra Hospital
Millar, Rebecca T.
Australia, Canberra
Canberra Hospital
McKenna, Toni E.
Australia, Waratah
Calvary Mater Newcastle
Bailey, Irene M.
Australia, Waratah
Calvary Mater Newcastle
Åneman, Erik Anders
Australia, Liverpool
Liverpool Hospital
Staudinger, Thomas
Austria, Vienna
Medizinische Universität Wien
Wittebole, Xavier
Belgium, Louvain-la-neuve
Université Catholique de Louvain
Bulpa, Pierre A.
Belgium, Dinant
Chu Dinant Godinne | Ucl Namur
Depuydt, Pieter O.
Belgium, Ghent
Universitair Ziekenhuis Gent
Piras, Cláudio
Unknown Affiliation
Beloncle, François Michel
Canada, Toronto
Saint Michael's Hospital University of Toronto
Cirone, Rob
Canada, Toronto
St. Joseph’s Health Centre Toronto
Goligher, Ewan C.
Canada, Toronto
Toronto Western Hospital University of Toronto
Rittayamai, Nuttapol
Canada, Toronto
Saint Michael's Hospital University of Toronto
Ferguson, Niall D.
Canada, Toronto
Toronto General Hospital
Mehta, Sangeeta K.
Canada, Toronto
Mount Sinai Hospital of University of Toronto
Bruhn, Alejandro R.
Chile, Santiago
Pontificia Universidad Católica de Chile
Qiu, Haibo
Unknown Affiliation
An, Youzhong
China, Beijing
Peking University People's Hospital
Wang, Chunting
China, Jinan
Shandong Provincial Hospital
Qin, Bingyu
China, Zhengzhou
Henan Provincial People's Hospital
Zhou, Suming
China, Nanjing
Jiangsu Province Hospital
Silesky-Jiménez, Juan Ignacio
Costa Rica, San José
Hospital San Juan de Dios
Maca, Jan
Czech Republic, Ostrava
University Hospital in Ostrava
Sklienka, Peter
Czech Republic, Ostrava
University Hospital in Ostrava
Gjedsted, Jakob
Denmark, Aarhus
Aarhus Universitetshospital
Nielsen, Jonas Bille
Unknown Affiliation
Burtin, Philippe
France, Montpellier
Clinique du Millénaire
Beuret, Pascal
France
Centre Hospitalier, France
Mercat, Alain
France, Angers
Chu Angers
Carteaux, Guillaume
France, Creteil
Hôpital Henri Mondor
de Prost, Nicolas
France, Creteil
Hôpital Henri Mondor
Chiche, Jean Daniel
France, Paris
Hopital Cochin Ap-hp
Daviaud, Fabrice
France, Paris
Hopital Cochin Ap-hp
Fartoukh, Muriel Sarah
France, Paris
Hôpital Tenon
Dellamonica, Jean
France, Nice
Centre Hospitalier Universitaire de Nice, Hôpital L'archet
Arnal, Jean Michel
Unknown Affiliation
Papazian, Laurent
France, Marseille
Hôpital Nord Ap-hm
Messika, Jonathan
France, Colombes
Hopital Louis-mourier
Combes, Alain
France, Paris
Hôpital Universitaire Pitié Salpêtrière
Béduneau, Gaëtan
France, Rouen
Chu Rouen Normandie
Zogheib, Élie H.
France, Amiens
Chu Amiens Picardie
Dupont, Hervé
France, Amiens
Chu Amiens Picardie
Besset, Sébastien L.
France, Cergy-pontoise
Centre Hospitalier René Dubos
Danin, Pierre Éric
France, Nice
Centre Hospitalier Universitaire de Nice, Hôpital L'archet
Badie, Julio C.
Unknown Affiliation
Schneider, Francis
France, Strasbourg
Hopital de Hautepierre
Rigaud, Jean Philippe
Unknown Affiliation
Duranteau, Jacques
Unknown Affiliation
Chabanne, Russell
France, Clermont-ferrand
Hopital Gabriel Montpied
Richecoeur, Jack R.
Unknown Affiliation
Robine, Adrien
Unknown Affiliation
Dres, Martin
France, Paris
Hôpital Universitaire Pitié Salpêtrière
Demoule, Alexandre
France, Paris
Hôpital Universitaire Pitié Salpêtrière
Baboi, Loredana
France, Lyon
Hopital de la Croix-rousse
Guérin, Claude
France, Lyon
Hopital de la Croix-rousse
Zacharowski, Kai D.
Germany, Frankfurt am Main
Universitätsklinikum Frankfurt
Meybohm, Patrick
Germany, Frankfurt am Main
Universitätsklinikum Frankfurt
Simon, Philipp
Germany, Leipzig
Universitätsklinikum Leipzig Und Medizinische Fakultät
Mouloudi, Eleni K.
Greece, Athens
Hippokration General Hospital
Jog, Sameer Arvind
India, Pune
Deenanath Mangeshkar Hospital and Research Center, Pune
Gurjar, Mohan
India, Lucknow
Sanjay Gandhi Postgraduate Institute of Medical Sciences
Baronia, Arvind Kumar
India, Lucknow
Sanjay Gandhi Postgraduate Institute of Medical Sciences
Ramakrishnan, N.
India, Chennai
Apollo Hospitals Group
Hashemian, Seyed Mohammad Reza
Iran, Tehran
Massih Daneshvari Educational Hospital
Nichol, Alistair D.
Ireland, Dublin
St Vincent's University Hospital
Clarkson, Kevin P.
Ireland, Galway
University Hospital Galway
Jaafar, Rola F.
Ireland, Galway
University Hospital Galway
Spadaro, S.
Italy, Cona
Azienda Ospedaliero-universitaria Di Ferrara
Protti, Alessandro
Italy, Milan
Fondazione Irccs Ca' Granda Ospedale Maggiore Policlinico
Montini, Luca Maria
Italy, Rome
Fondazione Policlinico Universitario Agostino Gemelli Irccs
Beck, Eduardo J.
Italy, Vimercate
Azienda Ospedaliera Di Desio e Vimercate
Cinnella, Gilda
Italy, Foggia
Ospedali Riuniti Di Foggia
Fossali, Tommaso
Italy, Milan
Ospedale Luigi Sacco - Polo Universitario
Colombo, Riccardo
Italy, Milan
Ospedale Luigi Sacco - Polo Universitario
Mojoli, Francesco
Italy, Pavia
Università Degli Studi Di Pavia
Foti, Giuseppe
Italy, Lecco
Azienda Ospedaliera Ospedale Di Lecco
Brazzi, Luca
Unknown Affiliation
Iotti, Giorgio Antonio
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Ñamendys-Silva, Silvio A.
Mexico, Tlalpan
Instituto Nacional de Cancerologia, México
Sanchez-Hurtado, Luis A.
Mexico, Mexico
Instituto Mexicano Del Seguro Social
del Carmen Marín, María
Mexico, Mexico
Hospital Regional 1° de Octubre Issste
Villagómez, Asisclo Jesús
Mexico, Mexico
Hospital Regional 1° de Octubre Issste
Dendane, Tarek
Morocco, Agdal Rabat
Ibn Sina Hospital, Agdal Rabat
Zeggwagh, Amine Ali
Morocco, Agdal Rabat
Ibn Sina Hospital, Agdal Rabat
Balkhi, Hicham
Morocco, Agdal Rabat
Military Hospital Mohammed V
Elkhayari, Mina
Unknown Affiliation
Samkaoui, Nacer
Unknown Affiliation
Ezzouine, Hanane
Morocco, Casablanca
Centre Hospitalier Universitaire Ibn Rochd
Benslama, Abdellatif
Morocco, Casablanca
Centre Hospitalier Universitaire Ibn Rochd
Amor, Mourad
Morocco, Rabat
Hôpital Des Spécialités, Rabat
Maazouzi, Wajdi
Morocco, Rabat
Hôpital Des Spécialités, Rabat
Schouten, Jeroen A.
Netherlands, Nijmegen
Canisius Wilhelmina Ziekenhuis
Heunks, Leo M.A.
Netherlands, Nijmegen
Radboud University Medical Center
Schultz, Marcus Josephus
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Browne, Troy S.
Unknown Affiliation
Navarra, Leanlove
Unknown Affiliation
Hunt, Anna L.
Unknown Affiliation
Newby, Lynette
Unknown Affiliation
McArthur, Colin J.
Unknown Affiliation
Andersen, Finn Husøy
Norway, Ålesund
Ålesund Hospital
Laake, Jon Henrik
Norway, Oslo
Rikshospitalet-radiumhospitalet hf
Barratt-Due, Andreas
Norway, Oslo
Rikshospitalet-radiumhospitalet hf
Söreide, Eldar
Norway, Stavanger
Stavanger Universitetssjukehus
Andruszkiewicz, Pawel
Poland, Warsaw
Medical University of Warsaw
Berger-Estilita, Joana M.
Portugal, Faro
Centro Hospitalar Universitário do Algarve
Tomescu, D. Rodica
Romania, Bucharest
Institutul Clinic Fundeni
Pǎpuricǎ, Marius
Unknown Affiliation
Gritsan, Alexey I.
Russian Federation, Krasnoyarsk
Voino-yasenetsky Krasnoyarsk State Medical University
Almekhlafi, Ghaleb A.
Unknown Affiliation
Maghrabi, Khalid A.
Saudi Arabia, Riyadh
King Faisal Specialist Hospital and Research Centre
Salahuddin, Nawal
Unknown Affiliation
Aisa, Tharwat Mahmoud
Saudi Arabia, Al Bahah
King Fahad Hospital Al-bahah
Arabi, Yaseen M.
Saudi Arabia, Riyadh
King Abdulaziz Medical City - Riyadh
Al-Dorzi, Hasan M.
Saudi Arabia, Riyadh
King Abdulaziz Medical City - Riyadh
Tabhan, Edgardo E.
Saudi Arabia, Riyadh
King Abdulaziz Medical City - Riyadh
Bolon, Stefan
South Africa, Johannesburg
Charlotte Maxeke Johannesburg Academic Hospital
Smith, Oliver I.
South Africa, Johannesburg
Charlotte Maxeke Johannesburg Academic Hospital
Mancebo, Jordi B.Y.J.
Spain, Barcelona
Hospital de la Santa Creu I Sant Pau
Aguirre-Bermeo, Hernán
Spain, Barcelona
Hospital de la Santa Creu I Sant Pau
Rialp, Gemma
Spain, Palma
Hospital Universitari Son Llàtzer
Forteza, Catalina
Spain, Palma
Hospital Universitari Son Llàtzer
Artigas, Antonio A.
Spain, Madrid
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Roche-Campo, Ferrán
Spain, Tarragona
Hospital Verge de la Cinta
Peñuelas, Óscar
Spain, Parla
Hospital Universitario Infanta Cristina
Broman, Lars Mikael
Sweden, Stockholm
Karolinska Universitetssjukhuset
Oscarsson, Anna
Sweden, Linkoping
Universitetssjukhuset I Linköping
Piquilloud, Lise
Switzerland, Lausanne
Centre Hospitalier Universitaire Vaudois
ElAtrous, Souheil
Tunisia, Mahdia
Hôpital Tahar Sfar
Bouchoucha, Slaheddine
Tunisia, Sousse
Hopital Farhat Hached Sousse
Chouchene, Imed
Tunisia, Sousse
Hopital Farhat Hached Sousse
Ouanes, Islem
Tunisia, Monastir
Chu Fattouma-bourguiba
Demirkiran, Oktay
Turkey, Istanbul
İstanbul Tıp Fakültesi
Özçelik, Menekşe
Turkey, Ankara
Ankara Üniversitesi
Meço, Başak Ceyda Orbey
Turkey, Ankara
Ankara Üniversitesi
McNamee, Lia
United Kingdom, Belfast
Royal Victoria Hospital Belfast
McAuley, Daniel F.
United Kingdom, Belfast
Royal Victoria Hospital Belfast
Kakar, Vivek
United Kingdom, London
King's College Hospital
Humphreys, Sally K.
United Kingdom, Bury st Edmunds
West Suffolk Nhs Foundation Trust
Ferguson, Andrew J.
United Kingdom, Portadown
Craigavon Area Hospital
Raj, Ashok Sundai
United Kingdom, London
Barts Health Nhs Trust
Thomas, Matthew J.C.
United Kingdom, Barnet
Barnet Hospital
Kannan, Santhanagopalan G.
United Kingdom, Birmingham
Birmingham City Hospital
Camsooksai, Julie
United Kingdom, Poole
University Hospitals Dorset Nhs Foundation Trust
Dempsey, Ged A.
United Kingdom, Liverpool
Aintree University Hospital
McKechnie, Stuart R.
United Kingdom, Oxford
John Radcliffe Hospital
Hutton, Paula J.
United Kingdom, Oxford
John Radcliffe Hospital
Di Tomasso, Nora
United Kingdom, London
St George's Hospital
Dawson, Heidi
United Kingdom, Edinburgh
Western General Hospital
Williams, Alexandra J.
United Kingdom, Preston
Royal Preston Hospital
Boyd, Owen F.
United Kingdom, Worthing
University Hospitals Sussex Nhs Foundation Trust
de Gordoa, Laura Ortiz Ruiz
United Kingdom, Worthing
University Hospitals Sussex Nhs Foundation Trust
Szakmany, Tamas
United Kingdom, Merthyr Tydfil
Prince Charles Hospital
Welters, Ingeborg Dorothea M.
United Kingdom, Liverpool
Royal Liverpool University Hospital
Careless, Jon P.
United Kingdom, Aylesbury
Buckinghamshire Healthcare Nhs Trust
Wise, Matt P.
United Kingdom, Cardiff
University Hospital of Wales
Cole, Jade M.
United Kingdom, Cardiff
University Hospital of Wales
Hurtado, Javier L.
Uruguay, Montevideo
Hospital Español
Nín, Nicholas
Uruguay, Montevideo
Hospital Español
Banner-Goodspeed, Valerie M.
United States, Boston
Beth Israel Deaconess Medical Center
Beitler, Jeremy R.
United States, Boston
Beth Israel Deaconess Medical Center
Bauer, Philippe R.
United States, Rochester
Mayo Clinic
Batra, Hitesh
United States, Birmingham
The University of Alabama at Birmingham
Kheir, Fayez M.
United States, New Orleans
Tulane University
Baron, Rebecca M.
United States, Boston
Brigham and Women's Hospital
Bumbaširević, Vesna D.
Serbia, Belgrade
Klinicki Centar Srbije
Jovanović, Bojan M.
Serbia, Belgrade
Klinicki Centar Srbije
François, Guy M.
Belgium, Brussels
European Society of Intensive Care Medicine
Ríos, Fernando Gonçalves
Unknown Affiliation
Sottiaux, Thierry M.
Unknown Affiliation
Lora, Fredy S.
Unknown Affiliation
Azevedo, Luciano César Pontes
Unknown Affiliation
Fan, Eddy
Unknown Affiliation
Bugedo, Guillermo
Unknown Affiliation
González, Marco A.
Unknown Affiliation
Silesky, Juan
Unknown Affiliation
Cerný, Vladimír
Unknown Affiliation
Jibaja, Manuel
Unknown Affiliation
Wrigge, Hermann
Unknown Affiliation
Matamis, Dimitrios
Unknown Affiliation
Ranero, Jorge Luis M.
Unknown Affiliation
Amin, Pravin R.
Unknown Affiliation
Kurahashi, Kiyoyasu
Unknown Affiliation
Palo, Jose Emmanuel M.
Unknown Affiliation
do Vale Fernandes, Antero
Unknown Affiliation
Sǎndesc, Dorel
Unknown Affiliation
Bumbasierevic, Vesna
Unknown Affiliation
Lorente, José Ángel A.
Unknown Affiliation
Larsson, Anders Sune
Unknown Affiliation
Abrouk, Fekri
Unknown Affiliation
Bajwa, Ed
Unknown Affiliation
Statistics
Citations: 71
Authors: 246
Affiliations: 325
Identifiers
Doi:
10.1186/s13054-018-2079-9
ISSN:
13648535
Research Areas
Health System And Policy
Study Design
Cohort Study