Epidemiological characteristics, ventilator management, and clinical outcome in patients receiving invasive ventilation in intensive care units from 10 Asian middle-incomeCountries (PRoVENT-iMiC): An International, Multicenter, Prospective Study
Document Type
Article
Publication Date
3-1-2021
Abstract
Epidemiology, ventilator management, and outcome in patients receiving invasive ventilation in intensive care units (ICUs) in middle-income countries are largely unknown. PRactice of VENTilation in Middle-income Countries is an international multicenter 4-week observational study of invasively ventilated adult patients in 54 ICUs from 10 Asian countries conducted in 2017/18. Study outcomes included major ventilator settings (including tidal volume VT] and positive end-expiratory pressure PEEP]); the proportion of patients at risk for acute respiratory distress syndrome (ARDS), according to the lung injury prediction score (LIPS), or with ARDS; the incidence of pulmonary complications; and ICU mortality. In 1,315 patients included, median V-T was similar in patients with LIPS < 4 and patients with LIPS >= 4, but lower in patients with ARDS (7.90 6.8-8.9], 8.0 6.8-9.2], and 7.0 5.8-8.4] mL/kg Predicted body weight; P = 0.0001). Median PEEP was similar in patients with LIPS < 4 and LIPS >= 4, but higher in patients withARDS(five 5-7], five 5-8], and 10 5-12] cmH(2)O; P < 0.0001). The proportions of patients with LIPS (3) 4 or with ARDS were 68% (95% CI: 66-71) and 7%(95% CI: 6-8), respectively. Pulmonary complications increased stepwise from patients with LIPS < 4 to patients with LIPS >= 4 and patients with ARDS (19%, 21%, and 38% respectively; P = 0.0002), with a similar trend in ICU mortality (17%, 34%, and 45% respectively; P < 0.0001). The capacity of the LIPS to predict development of ARDS was poor (receiver operating characteristic ROC] area under the curve AUC] of 0.62, 95% CI: 0.54-0.70). In Asian middle-income countries, where two-thirds of ventilated patients are at risk for ARDS according to the LIPS and pulmonary complications are frequent, setting of V-T is globally in line with current recommendations.
Keywords
Public, Environmental & occupational HealthTropical medicine
Publication Title
American Journal of Tropical Medicine and Hygiene
Recommended Citation
Pisani, Luigi; Algera, Anna Geke; Serpa Neto, Ary; Ahsan, Areef; Beane, Abigail; Chittawatanarat, Kaweesak; Faiz, Abul; Haniffa, Rashan; Hashemian, Seyed MohammadReza; Hashmi, Madiha; Imad, Hisham Ahmed; Indraratna, Kanishka; Iyer, Shivakumar; Kayastha, Gyan; Krishna, Bhuvana; Ling, Tai Li; Moosa, Hassan; Nadjm, Behzad; Pattnaik, Rajyabardhan; Sampath, Sriram; Thwaites, Louise; Tun, Ni Ni; Yunos, Nor'azim Mohd; Grasso, Salvatore; Paulus, Frederique; de Abreu, Marcelo Gama; Pelosi, Paolo; Day, Nick; White, Nicholas J.; and Dondorp, Arjen M., "Epidemiological characteristics, ventilator management, and clinical outcome in patients receiving invasive ventilation in intensive care units from 10 Asian middle-incomeCountries (PRoVENT-iMiC): An International, Multicenter, Prospective Study" (2021). Research Publications (2021 to 2025). 11529.
https://knova.um.edu.my/research_publications_2021_2025/11529
Divisions
anaesthesiology
Funders
Wellcome Trust [107367/Z/15/Z],[089276/B/09/7]
Volume
104
Issue
3
Publisher
Amer Soc Trop Med & Hygiene
Publisher Location
8000 WESTPARK DR, STE 130, MCLEAN, VA 22101 USA