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Erschienen in: Intensive Care Medicine 12/2011

01.12.2011 | Original

The ALIEN study: incidence and outcome of acute respiratory distress syndrome in the era of lung protective ventilation

verfasst von: Jesús Villar, Jesús Blanco, José Manuel Añón, Antonio Santos-Bouza, Lluís Blanch, Alfonso Ambrós, Francisco Gandía, Demetrio Carriedo, Fernando Mosteiro, Santiago Basaldúa, Rosa Lidia Fernández, Robert M. Kacmarek, on behalf of the ALIEN Network

Erschienen in: Intensive Care Medicine | Ausgabe 12/2011

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Abstract

Purpose

While our understanding of the pathogenesis and management of acute respiratory distress syndrome (ARDS) has improved over the past decade, estimates of its incidence have been controversial. The goal of this study was to examine ARDS incidence and outcome under current lung protective ventilatory support practices before and after the diagnosis of ARDS.

Methods

This was a 1-year prospective, multicenter, observational study in 13 geographical areas of Spain (serving a population of 3.55 million at least 18 years of age) between November 2008 and October 2009. Subjects comprised all consecutive patients meeting American-European Consensus Criteria for ARDS. Data on ventilatory management, gas exchange, hemodynamics, and organ dysfunction were collected.

Results

A total of 255 mechanically ventilated patients fulfilled the ARDS definition, representing an incidence of 7.2/100,000 population/year. Pneumonia and sepsis were the most common causes of ARDS. At the time of meeting ARDS criteria, mean PaO2/FiO2 was 114 ± 40 mmHg, mean tidal volume was 7.2 ± 1.1 ml/kg predicted body weight, mean plateau pressure was 26 ± 5 cmH2O, and mean positive end-expiratory pressure (PEEP) was 9.3 ± 2.4 cmH2O. Overall ARDS intensive care unit (ICU) and hospital mortality was 42.7% (95%CI 37.7–47.8) and 47.8% (95%CI 42.8–53.0), respectively.

Conclusions

This is the first study to prospectively estimate the ARDS incidence during the routine application of lung protective ventilation. Our findings support previous estimates in Europe and are an order of magnitude lower than those reported in the USA and Australia. Despite use of lung protective ventilation, overall ICU and hospital mortality of ARDS patients is still higher than 40%.
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Metadaten
Titel
The ALIEN study: incidence and outcome of acute respiratory distress syndrome in the era of lung protective ventilation
verfasst von
Jesús Villar
Jesús Blanco
José Manuel Añón
Antonio Santos-Bouza
Lluís Blanch
Alfonso Ambrós
Francisco Gandía
Demetrio Carriedo
Fernando Mosteiro
Santiago Basaldúa
Rosa Lidia Fernández
Robert M. Kacmarek
on behalf of the ALIEN Network
Publikationsdatum
01.12.2011
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 12/2011
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-011-2380-4

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