Background
Methods
Study aim
Study design
Patients
Protocol description
Data collection
Data analysis
Statistical analysis
Results
Population
Variable | Patients characteristics n = 107 |
---|---|
Age (year) | 65 ± 12 (35; 89) |
Male sex | 73 (68%) |
Body mass index (kg m−2) | 29 ± 7 (16; 54) |
SAPS II | 62 ± 18 (32; 118) |
Admission category | |
Medical | 103 (96%) |
Emergent surgery | 2 (2%) |
Elective surgery | 1 (1%) |
Trauma | 1 (1%) |
ARDS severity | |
Moderate | 30 (28%) |
Severe | 77 (72%) |
Time between ICU admission and ARDS onset | 2 ± 4 (− 3; 27) |
ARDS risk factorsa | |
Pneumonia | 79 (74%) |
Aspiration | 34 (32%) |
Extra pulmonary sepsis | 10 (9%) |
None | 3 (3%) |
Acute cor pulmonale | 10 (9%) |
Variables | Session characteristics n = 197 |
---|---|
Number of PP sessions per patient | 2 ± 2 |
Time between ARDS onset and PP session onset (day) | 3 ± 3 |
Duration of PP session (h) | 16 ± 3 |
SOFA score | 15 ± 4 |
Body weight at PP session onset (kg) | 86 ± 19 |
Cumulative fluid balance at PP session onset (kg) | 2.3 ± 6.5 |
Fluid balance during PP session (kg) | 0.8 ± 3.3 |
Fluid challenge during PP session | 78 (40%) |
Volume of fluid challenges during PP session (mL) | 505 ± 1069 |
Renal replacement therapy | 84 (43%) |
Dobutamine administration | 62 (31%) |
Vasopressor administration | 166 (84%) |
Inhaled nitric oxide | 39 (20%) |
Neuromuscular blocking agents | 182 (92%) |
O2 responders to PP | 157 (80%) |
CO2 responders to PP | 97 (49%) |
O2 and CO2 responders to PP | 85 (43%) |
Hemodynamic and respiratory measurements
Variables | T1 | T2 | T3 | T4 |
---|---|---|---|---|
HR (min−1) | 98 ± 23 | 99 ± 20a | 96 ± 20 | 95 ± 21 |
MAP (mmHg) | 76 ± 10 | 79 ± 12c | 77 ± 12 | 78 ± 14 |
CVP (cm H2O) | 13 ± 5 | 14 ± 5c | 13 ± 5 | 14 ± 5 |
CI (L min m−2) | 3.5 ± 1.3a | 3.4 ± 1.2a | 3.4 ± 1.1a | 3.2 ± 1.1 |
GEF (%) | 21 ± 7 | 20 ± 7c | 21 ± 8 | 21 ± 7 |
EVLWI (mL kg−1 PBW) | 13.8 ± 4.4 | 14.2 ± 4.7a | 13.7 ± 4.7 | 13.1 ± 4.0 |
PVPI | 2.6 ± 1.0b | 2.5 ± 0.9 | 2.4 ± 0.9 | 2.5 ± 0.9 |
GEDVI (mL m−2) | 719 ± 193 | 738 ± 185a,c | 757 ± 209a,c | 714 ± 200 |
CFI (min−1) | 5.0 ± 1.9 | 4.8 ± 1.8c | 4.8 ± 1.8c | 4.7 ± 1.8c |
PTV (mL) | 1163 ± 362a | 1189 ± 359a | 1173 ± 354a | 1116 ± 327 |
ITTV (mL) | 2539 ± 653 | 2602 ± 638a,c | 2619 ± 664a,c | 2482 ± 655 |
DO2 (mL min m−2) | 416 ± 145 | NA | 414 ± 139 | 387 ± 126b,c |
Vasopressor dose* (µg kg min−1) | 0.92 ± 1.66 | 0.92 ± 2.04 | 0.84 ± 1.67c | 0.88 ± 1.76c |
Dobutamine dose** (µg kg min−1) | 2.6 ± 6.0 | 2.6 ± 5.8 | 2.8 ± 6.1 | 3.0 ± 6.2 |
Volume of fluid challenge since preceding time point*** (mL) | NA | 158 ± 519 | 224 ± 566 | 123 ± 340 |
Variables | T1 | T3 | T4 |
---|---|---|---|
VT (mL kg−1 PBW) | 6.2 ± 0.7 | 6.2 ± 0.8 | 6.1 ± 0.8 |
RR (min−1) | 29 ± 5 | 29 ± 5 | 29 ± 5 |
I:E ratio (%) | 42 ± 11 | 40 ± 9 | 39 ± 9 |
PEEP (cm H2O) | 10 ± 3a,b | 9 ± 3 | 9 ± 3 |
PEEPtot (cm H2O) | 11 ± 2 | 10 ± 3 | 10 ± 3 |
Pplat (cm H2O) | 23 ± 4 | 22 ± 5c | 22 ± 4c |
Δp (cm H2O) | 12 ± 4 | 11 ± 4 | 11 ± 3 |
pH | 7.35 ± 0.10 | 7.38 ± 0.09a,c | 7.37 ± 0.09c |
PaCO2 (mmHg) | 45 ± 10 | 43 ± 11 | 44 ± 10 |
PaO2/FiO2 | 112 ± 28 | 179 ± 62a,c | 153 ± 60c |
Lactate (mmol L−1) | 3.6 ± 3.2 | 3.3 ± 3.0 | 3.2 ± 3.0 |
Hemoglobin (g L−1) | 101 ± 22 | 98 ± 21c | 98 ± 20c |