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Lung-protective Ventilation in Patients with Brain Injury
- Source :
- Chinese Medical Journal, Vol 129, Iss 14, Pp 1643-1651 (2016), Chinese Medical Journal
- Publication Year :
- 2016
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2016.
-
Abstract
- Background: Over the years, the mechanical ventilation (MV) strategy has changed worldwide. The aim of the present study was to describe the ventilation practices, particularly lung-protective ventilation (LPV), among brain-injured patients in China. Methods: This study was a multicenter, 1-day, cross-sectional study in 47 Intensive Care Units (ICUs) across China. Mechanically ventilated patients (18 years and older) with brain injury in a participating ICU during the time of the study, including traumatic brain injury, stroke, postoperation with intracranial tumor, hypoxic-ischemic encephalopathy, intracranial infection, and idiopathic epilepsy, were enrolled. Demographic data, primary diagnoses, indications for MV, MV modes and settings, and prognoses on the 60 th day were collected. Multivariable logistic analysis was used to assess factors that might affect the use of LPV. Results: A total of 104 patients were enrolled in the present study, 87 (83.7%) of whom were identified with severe brain injury based on a Glasgow Coma Scale ≤8 points. Synchronized intermittent mandatory ventilation (SIMV) was the most frequent ventilator mode, accounting for 46.2% of the entire cohort. The median tidal volume was set to 8.0 ml/kg (interquartile range [IQR], 7.0–8.9 ml/kg) of the predicted body weight; 50 (48.1%) patients received LPV. The median positive end-expiratory pressure (PEEP) was set to 5 cmH 2 O (IQR, 5–6 cmH 2 O). No PEEP values were higher than 10 cmH 2 O. Compared with partially mandatory ventilation, supportive and spontaneous ventilation practices were associated with LPV. There were no significant differences in mortality and MV duration between patients subjected to LPV and those were not. Conclusions: Among brain-injured patients in China, SIMV was the most frequent ventilation mode. Nearly one-half of the brain-injured patients received LPV. Patients under supportive and spontaneous ventilation were more likely to receive LPV. Trial Registration: ClinicalTrials.org NCT02517073 https://clinicaltrials.gov/ct2/show/NCT02517073 .
- Subjects :
- Adult
Male
China
Pediatrics
medicine.medical_specialty
Epidemiology
Mechanical Ventilation
medicine.medical_treatment
lcsh:Medicine
Brain Injury
Lung-protective Ventilation
03 medical and health sciences
0302 clinical medicine
Interquartile range
Surveys and Questionnaires
Intensive care
Brain Injuries, Traumatic
Humans
Medicine
Stroke
Tidal volume
Aged
Mechanical ventilation
business.industry
lcsh:R
Glasgow Coma Scale
030208 emergency & critical care medicine
General Medicine
Middle Aged
medicine.disease
Respiration, Artificial
Intensive Care Units
Cross-Sectional Studies
030228 respiratory system
Brain Injuries
Anesthesia
Hypoxia-Ischemia, Brain
Cohort
Breathing
Female
Original Article
business
Subjects
Details
- ISSN :
- 03666999
- Volume :
- 129
- Database :
- OpenAIRE
- Journal :
- Chinese Medical Journal
- Accession number :
- edsair.doi.dedup.....2eb2bacfbbb2d36003d06be05969599c