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1. Ventilation practices in burn patients—an international prospective observational cohort study

Author

Schultz, Marcus J, Horn, Janneke, Hollmann, Markus W, Preckel, Benedikt, Glas, Gerie J, Colpaert, Kirsten, Malbrain, Manu, Neto, Ary Serpa, Asehnoune, Karim, de Abreu, Marcello Gamma, Martin-Loeches, Ignacio, Pelosi, Paolo, Sjöberg, Folke, Binnekade, Jan M, Cleffken, Berry, Juffermans, Nicole P, Knape, Paul, Loef, Bert G, Mackie, David P, Enkhbaatar, Perenlei, Depetris, Nadia, Perner, Anders, Herrero, Eva, Cachafeiro, Lucia, Jeschke, Marc, Lipman, Jeffrey, Legrand, Matthieu, Horter, Johannes, Lavrentieva, Athina, Glas, Gerie, Kazemi, Alex, Guttormsen, Anne Berit, Huss, Frederik, Kol, Mark, Wong, Helen, Starr, Therese, De Crop, Luc, de Oliveira Filho, Wilson, Silva, João Manoel, Grion, Cintia MC, Jeschke, Marc G, Burnett, Marjorie, Mondrup, Frederik, Ravat, Francois, Fontaine, Mathieu, Asehoune, Karim, Le Floch, Renan, Jeanne, Mathieu, Bacus, Morgane, Chaussard, Maïté, Lehnhardt, Marcus, Mikhail, Bassem Daniel, Gille, Jochen, Sharkey, Aidan, Trommel, Nicole, Reidinga, Auke C, Vieleers, Nadine, Tilsley, Anna, Onarheim, Henning, Bouza, Maria Teresa, Agrifoglio, Alexander, Fredén, Filip, Palmieri, Tina, Painting, Lynda E, and investigators, LAMiNAR

Subjects
Paediatrics, Biomedical and Clinical Sciences, Physical Injury - Accidents and Adverse Effects, Clinical Research, Lung, Respiratory, Mechanical ventilation, Inhalation trauma, Lung-protective, Critical care, LAMiNAR investigators, Clinical sciences, Medical biotechnology, Biomedical engineering
Abstract

BackgroundIt is unknown whether lung-protective ventilation is applied in burn patients and whether they benefit from it. This study aimed to determine ventilation practices in burn intensive care units (ICUs) and investigate the association between lung-protective ventilation and the number of ventilator-free days and alive at day 28 (VFD-28).MethodsThis is an international prospective observational cohort study including adult burn patients requiring mechanical ventilation. Low tidal volume (V T) was defined as V T ≤ 8 mL/kg predicted body weight (PBW). Levels of positive end-expiratory pressure (PEEP) and maximum airway pressures were collected. The association between V T and VFD-28 was analyzed using a competing risk model. Ventilation settings were presented for all patients, focusing on the first day of ventilation. We also compared ventilation settings between patients with and without inhalation trauma.ResultsA total of 160 patients from 28 ICUs in 16 countries were included. Low V T was used in 74% of patients, median V T size was 7.3 [interquartile range (IQR) 6.2-8.3] mL/kg PBW and did not differ between patients with and without inhalation trauma (p = 0.58). Median VFD-28 was 17 (IQR 0-26), without a difference between ventilation with low or high V T (p = 0.98). All patients were ventilated with PEEP levels ≥5 cmH2O; 80% of patients had maximum airway pressures

Published
2021

2. Ventilation practices in burn patients : an international prospective observational cohort study

Author

Glas, Gerie J, Horn, Janneke, Hollmann, Markus W, Preckel, Benedikt, Colpaert, Kirsten, Malbrain, Manu, Neto, Ary Serpa, Asehnoune, Karim, de Abreu, Marcello Gamma, Martin-Loeches, Ignacio, Pelosi, Paolo, Sjöberg, Folke, Binnekade, Jan M, Cleffken, Berry, Juffermans, Nicole P, Knape, Paul, Loef, Bert G, Mackie, David P, Enkhbaatar, Perenlei, Depetris, Nadia, Perner, Anders, Herrero, Eva, Cachafeiro, Lucia, Jeschke, Marc, Lipman, Jeffrey, Legrand, Matthieu, Horter, Johannes, Lavrentieva, Athina, Kazemi, Alex, Guttormsen, Anne Berit, Huss, Frederik, Kol, Mark, Wong, Helen, Starr, Therese, De Crop, Luc, de Oliveira Filho, Wilson, Manoel Silva Junior, João, Grion, Cintia M C, Burnett, Marjorie, Mondrup, Frederik, Ravat, Francois, Fontaine, Mathieu, Floch, Renan Le, Jeanne, Mathieu, Bacus, Morgane, Chaussard, Maïté, Lehnhardt, Marcus, Mikhail, Bassem Daniel, Gille, Jochen, Sharkey, Aidan, Trommel, Nicole, Reidinga, Auke C, Vieleers, Nadine, Tilsley, Anna, Onarheim, Henning, Bouza, Maria Teresa, Agrifoglio, Alexander, Fredén, Filip, Palmieri, Tina, Painting, Lynda E, Schultz, Marcus J, and LAMiNAR investigators, [missing]

Subjects
OUTCOMES, MORTALITY, CONSERVATIVE OXYGEN-THERAPY, Biomedical Engineering, RESPIRATORY-DISTRESS-SYNDROME, Dermatology, ASSOCIATION, Critical Care and Intensive Care Medicine, INTENSIVE-CARE UNITS, PROTECTIVE VENTILATION, PREVENTION, MECHANICAL VENTILATION, Critical care, INHALATION INJURY, Lung-protective, Medicine and Health Sciences, Emergency Medicine, Immunology and Allergy, Surgery, Inhalation trauma
Abstract

Background: It is unknown whether lung-protective ventilation is applied in burn patients and whether they benefit from it. This study aimed to determine ventilation practices in burn intensive care units (ICUs) and investigate the association between lung-protective ventilation and the number of ventilator-free days and alive at day 28 (VFD-28). Methods: This is an international prospective observational cohort study including adult burn patients requiring mechanical ventilation. Low tidal volume (V-T) was defined as V-T = 5 cmH(2)O; 80% of patients had maximum airway pressures

Published
2021

3. Ventilation practices in burn patients-an international prospective observational cohort study

Author

Glas, Gerie J., Horn, Janneke, Hollmann, Markus W., Preckel, Benedikt, Colpaert, Kirsten, Malbrain, Manu, Neto, Ary Serpa, Asehnoune, Karim, de Abreu, Marcello Gamma, Martin-Loeches, Ignacio, Pelosi, Paolo, Sjöberg, Folke, Binnekade, Jan M., Cleffken, Berry, Juffermans, Nicole P., Knape, Paul, Loef, Bert G., Mackie, David P., Enkhbaatar, Perenlei, Depetris, Nadia, Perner, Anders, Herrero, Eva, Cachafeiro, Lucia, Jeschke, Marc, Lipman, Jeffrey, Legrand, Matthieu, Horter, Johannes, Lavrentieva, Athina, Kazemi, Alex, Guttormsen, Anne Berit, Huss, Frederik, Kol, Mark, Wong, Helen, Starr, Therese, De Crop, Luc, de Oliveira Filho, Wilson, Silva Junior, Joao Manoel, Grion, Cintia M. C., Burnett, Marjorie, Mondrup, Frederik, Ravat, Francois, Fontaine, Mathieu, Le Floch, Renan, Jeanne, Mathieu, Bacus, Morgane, Chaussard, Maite, Lehnhardt, Marcus, Mikhail, Bassem Daniel, Gille, Jochen, Sharkey, Aidan, Trommel, Nicole, Reidinga, Auke C., Vieleers, Nadine, Tilsley, Anna, Onarheim, Henning, Teresa Bouza, Maria, Agrifoglio, Alexander, Freden, Filip, Palmieri, Tina, Painting, Lynda E., Schultz, Marcus J., Glas, Gerie J., Horn, Janneke, Hollmann, Markus W., Preckel, Benedikt, Colpaert, Kirsten, Malbrain, Manu, Neto, Ary Serpa, Asehnoune, Karim, de Abreu, Marcello Gamma, Martin-Loeches, Ignacio, Pelosi, Paolo, Sjöberg, Folke, Binnekade, Jan M., Cleffken, Berry, Juffermans, Nicole P., Knape, Paul, Loef, Bert G., Mackie, David P., Enkhbaatar, Perenlei, Depetris, Nadia, Perner, Anders, Herrero, Eva, Cachafeiro, Lucia, Jeschke, Marc, Lipman, Jeffrey, Legrand, Matthieu, Horter, Johannes, Lavrentieva, Athina, Kazemi, Alex, Guttormsen, Anne Berit, Huss, Frederik, Kol, Mark, Wong, Helen, Starr, Therese, De Crop, Luc, de Oliveira Filho, Wilson, Silva Junior, Joao Manoel, Grion, Cintia M. C., Burnett, Marjorie, Mondrup, Frederik, Ravat, Francois, Fontaine, Mathieu, Le Floch, Renan, Jeanne, Mathieu, Bacus, Morgane, Chaussard, Maite, Lehnhardt, Marcus, Mikhail, Bassem Daniel, Gille, Jochen, Sharkey, Aidan, Trommel, Nicole, Reidinga, Auke C., Vieleers, Nadine, Tilsley, Anna, Onarheim, Henning, Teresa Bouza, Maria, Agrifoglio, Alexander, Freden, Filip, Palmieri, Tina, Painting, Lynda E., and Schultz, Marcus J.

Abstract

Background: It is unknown whether lung-protective ventilation is applied in burn patients and whether they benefit from it. This study aimed to determine ventilation practices in burn intensive care units (ICUs) and investigate the association between lung-protective ventilation and the number of ventilator-free days and alive at day 28 (VFD-28). Methods: This is an international prospective observational cohort study including adult burn patients requiring mechanical ventilation. Low tidal volume (V-T) was defined as V-T <= 8 mL/kg predicted body weight (PBW). Levels of positive end-expiratory pressure (PEEP) and maximum airway pressures were collected. The association between V-T and VFD-28 was analyzed using a competing risk model. Ventilation settings were presented for all patients, focusing on the first day of ventilation. We also compared ventilation settings between patients with and without inhalation trauma. Results: A total of 160 patients from 28 ICUs in 16 countries were included. Low V-T was used in 74% of patients, median V-T size was 7.3 [interquartile range (IQR) 6.2-8.3] mL/kg PBW and did not differ between patients with and without inhalation trauma (p= 0.58). Median VFD-28 was 17 (IQR 0-26), without a difference between ventilation with low or high V-T (p= 0.98). All patients were ventilated with PEEP levels >= 5 cmH(2)O; 80% of patients had maximum airway pressures <30 cmH(2)O. Conclusion: In this international cohort study we found that lung-protective ventilation is used in the majority of burn patients, irrespective of the presence of inhalation trauma. Use of low V-T was not associated with a reduction in VFD-28., Funding Agencies|Nederlandse Brandwonden Stichting (the Dutch Burn Association, Beverwijk, The Netherlands)Netherlands Government

Published
2021
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4. Ventilation practices in burn patients-an international prospective observational cohort study.

Author

Schultz MJ, Horn J, Hollmann MW, Preckel B, Glas GJ, Colpaert K, Malbrain M, Neto AS, Asehnoune K, de Abreu MG, Martin-Loeches I, Pelosi P, Sjöberg F, Binnekade JM, Cleffken B, Juffermans NP, Knape P, Loef BG, Mackie DP, Enkhbaatar P, Depetris N, Perner A, Herrero E, Cachafeiro L, Jeschke M, Lipman J, Legrand M, Horter J, Lavrentieva A, Glas G, Kazemi A, Guttormsen AB, Huss F, Kol M, Wong H, Starr T, De Crop L, de Oliveira Filho W, Manoel Silva Junior J, Grion CMC, Jeschke MG, Burnett M, Mondrup F, Ravat F, Fontaine M, Asehoune K, Floch RL, Jeanne M, Bacus M, Chaussard M, Lehnhardt M, Mikhail BD, Gille J, Sharkey A, Trommel N, Reidinga AC, Vieleers N, Tilsley A, Onarheim H, Bouza MT, Agrifoglio A, Fredén F, Palmieri T, and Painting LE

Abstract

Background: It is unknown whether lung-protective ventilation is applied in burn patients and whether they benefit from it. This study aimed to determine ventilation practices in burn intensive care units (ICUs) and investigate the association between lung-protective ventilation and the number of ventilator-free days and alive at day 28 (VFD-28)., Methods: This is an international prospective observational cohort study including adult burn patients requiring mechanical ventilation. Low tidal volume ( V T ) was defined as V T  ≤ 8 mL/kg predicted body weight (PBW). Levels of positive end-expiratory pressure (PEEP) and maximum airway pressures were collected. The association between V T and VFD-28 was analyzed using a competing risk model. Ventilation settings were presented for all patients, focusing on the first day of ventilation. We also compared ventilation settings between patients with and without inhalation trauma., Results: A total of 160 patients from 28 ICUs in 16 countries were included. Low V T was used in 74% of patients, median V T size was 7.3 [interquartile range (IQR) 6.2-8.3] mL/kg PBW and did not differ between patients with and without inhalation trauma ( p  = 0.58). Median VFD-28 was 17 (IQR 0-26), without a difference between ventilation with low or high V T ( p  = 0.98). All patients were ventilated with PEEP levels ≥5 cmH 2 O; 80% of patients had maximum airway pressures <30 cmH 2 O., Conclusion: In this international cohort study we found that lung-protective ventilation is used in the majority of burn patients, irrespective of the presence of inhalation trauma. Use of low V T was not associated with a reduction in VFD-28., Trial Registration: Clinicaltrials.gov NCT02312869. Date of registration: 9 December 2014., (© The Author(s) 2021. Published by Oxford University Press.)

Published
2021
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