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01.08.2009 | Original

Acute respiratory failure in intensive care units. FINNALI: a prospective cohort study

verfasst von: Rita Linko, Marjatta Okkonen, Ville Pettilä, Juha Perttilä, Ilkka Parviainen, Esko Ruokonen, Jyrki Tenhunen, Tero Ala-Kokko, Tero Varpula, The FINNALI-study group

Erschienen in: Intensive Care Medicine | Ausgabe 8/2009

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Abstract

Objective

To evaluate the incidence, treatment and mortality of acute respiratory failure (ARF) in Finnish intensive care units (ICUs).

Study design

Prospective multicentre cohort study.

Methods

All adult patients in 25 ICUs were screened for use of invasive or non-invasive ventilatory support during an 8-week period. Patients needing ventilatory support for more than 6 h were included and defined as ARF patients. Risk factors for ARF and details of prior chronic health status were assessed. Ventilatory and concomitant treatments were evaluated and recorded daily throughout the ICU stay. ICU and 90-day mortalities were assessed.

Results

A total of 958 (39%) from the 2,473 admitted patients were treated with ventilatory support for more than 6 h. Incidence of ARF, acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) was 149.5, 10.6 and 5.0/100,000 per year, respectively. Ventilatory support was started with non-invasive interfaces in 183 of 958 (19%) patients. Ventilatory modes allowing triggering of spontaneous breaths were preferred (81%). Median tidal volume/predicted body weight was 8.7 (7.6–9.9) ml/kg and plateau pressure 19 (16–23) cmH₂O. The 90-day mortality of ARF was 31%.

Conclusions

While the incidence of ARF requiring ventilatory support is higher, the incidence of ALI and ARDS seems to be lower in Finland than previously reported in other countries. Tidal volumes are higher than recommended in the concept of lung protective strategy. However, restriction of peak airway pressure was used in the majority of ARF patients.

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Titel: Acute respiratory failure in intensive care units. FINNALI: a prospective cohort study
verfasst von: Rita Linko
Marjatta Okkonen
Ville Pettilä
Juha Perttilä
Ilkka Parviainen
Esko Ruokonen
Jyrki Tenhunen
Tero Ala-Kokko
Tero Varpula
The FINNALI-study group
Publikationsdatum: 01.08.2009
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 8/2009
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-009-1519-z

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