Practice of diagnosis and management of acute respiratory distress syndrome in mainland China: a cross-sectional study
Although acute respiratory distress syndrome (ARDS) has been recognized for more than 50 years, limited information exists about the incidence and management of ARDS in mainland China. To evaluate the potential for improvement in management of patients with ARDS, this study was designed to describe...
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| creator | Liu, Ling Yang, Yi Gao, Zhiwei Li, Maoqin Mu, Xinwei Ma, Xiaochun Li, Guicheng Sun, Wen Wang, Xue Gu, Qin Zheng, Ruiqiang Zhao, Hongsheng Ao, Dan Yu, Wenkui Wang, Yushan Chen, Kang Yan, Jie Li, Jianguo Cai, Guolong Wang, Yurong Wang, Hongliang Kang, Yan Slutsky, Arthur S Liu, Songqiao Xie, Jianfen Qiu, Haibo |
| description | Although acute respiratory distress syndrome (ARDS) has been recognized for more than 50 years, limited information exists about the incidence and management of ARDS in mainland China. To evaluate the potential for improvement in management of patients with ARDS, this study was designed to describe the incidence and management of ARDS in mainland China.
National prospective multicenter observational study over one month (August 31
to September 30
, 2012) of all patients who fulfilled the Berlin or American European Consensus Conference (AECC) definition of ARDS in 20 intensive care units, with data collection related to the management of ARDS, patient characteristics and outcomes.
Of the 1,814 patients admitted during the enrollment period, 149 (8.2%) and 147 (8.1%) patients were diagnosed by AECC and Berlin definition, respectively. Lung protective strategy with low tidal volume (Vt) (≤8 mL/kg) and limitation of the plateau pressure (Pplat) (≤30 cmH
O) was performed in 75.2% patients. And, 36%, 21.1% and 4.1% patients with severe, moderate and mild ARDS had the driving pressure more than 14 cmH
O (P |
| doi_str_mv | 10.21037/jtd.2018.08.137 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6196194</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2132290607</sourcerecordid><originalsourceid>FETCH-LOGICAL-c462t-6901c7da7b70b5ed5fdab1f55f33ff0fb585bf414db0d7c582ec4931aefae7233</originalsourceid><addsrcrecordid>eNpVUU1r3DAUFKWhCUnuPRUde_FWH7Zl91AoS_oBgfaQnMWz9LRRsKWtJAf231ebpCEVAj3xZuZpNIS852wjOJPq032xG8H4sGHDhkv1hpwJpkTDWzm-fVWfksuc71ldPRNCqXfkVLKW92pQZ-ThdwJTvEEaHbUediFmnykESxcIsMMFQzn2wKwFacK89wlKTIeKzqXeM82HYFNckPpQST7MR_b2zgf4TIGaFHNuMtYpMcBMc1nt4YKcOJgzXj6f5-T229XN9kdz_ev7z-3X68a0vShNPzJulAU1KTZ1aDtnYeKu65yUzjE3dUM3uZa3dmJWmW4QaNpRckAHqISU5-TLk-5-nRa0pppJMOt98gukg47g9f-d4O_0Lj7ono91t1Xg47NAin9WzEUvPhucq0eMa9aCSyHG-rOqQtkT9NFxQvcyhjP9mJiuieljYpoNuiZWKR9eP--F8C8f-ReIOpYu</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2132290607</pqid></control><display><type>article</type><title>Practice of diagnosis and management of acute respiratory distress syndrome in mainland China: a cross-sectional study</title><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Liu, Ling ; Yang, Yi ; Gao, Zhiwei ; Li, Maoqin ; Mu, Xinwei ; Ma, Xiaochun ; Li, Guicheng ; Sun, Wen ; Wang, Xue ; Gu, Qin ; Zheng, Ruiqiang ; Zhao, Hongsheng ; Ao, Dan ; Yu, Wenkui ; Wang, Yushan ; Chen, Kang ; Yan, Jie ; Li, Jianguo ; Cai, Guolong ; Wang, Yurong ; Wang, Hongliang ; Kang, Yan ; Slutsky, Arthur S ; Liu, Songqiao ; Xie, Jianfen ; Qiu, Haibo</creator><creatorcontrib>Liu, Ling ; Yang, Yi ; Gao, Zhiwei ; Li, Maoqin ; Mu, Xinwei ; Ma, Xiaochun ; Li, Guicheng ; Sun, Wen ; Wang, Xue ; Gu, Qin ; Zheng, Ruiqiang ; Zhao, Hongsheng ; Ao, Dan ; Yu, Wenkui ; Wang, Yushan ; Chen, Kang ; Yan, Jie ; Li, Jianguo ; Cai, Guolong ; Wang, Yurong ; Wang, Hongliang ; Kang, Yan ; Slutsky, Arthur S ; Liu, Songqiao ; Xie, Jianfen ; Qiu, Haibo</creatorcontrib><description>Although acute respiratory distress syndrome (ARDS) has been recognized for more than 50 years, limited information exists about the incidence and management of ARDS in mainland China. To evaluate the potential for improvement in management of patients with ARDS, this study was designed to describe the incidence and management of ARDS in mainland China.
National prospective multicenter observational study over one month (August 31
to September 30
, 2012) of all patients who fulfilled the Berlin or American European Consensus Conference (AECC) definition of ARDS in 20 intensive care units, with data collection related to the management of ARDS, patient characteristics and outcomes.
Of the 1,814 patients admitted during the enrollment period, 149 (8.2%) and 147 (8.1%) patients were diagnosed by AECC and Berlin definition, respectively. Lung protective strategy with low tidal volume (Vt) (≤8 mL/kg) and limitation of the plateau pressure (Pplat) (≤30 cmH
O) was performed in 75.2% patients. And, 36%, 21.1% and 4.1% patients with severe, moderate and mild ARDS had the driving pressure more than 14 cmH
O (P<0.05). Pplat and driving pressure increased significantly in patients with a higher degree of ARDS severity (P=0.002 and P<0.001, respectively), but Vt were comparable in the three groups (P>0.05). In severe ARDS, patient median positive end expiratory pressure (PEEP) was 10.0 (8.0-11.3) cmH
O and median FiO
was 90%. A recruitment maneuver was performed in 35.5% of the patients, and 8.7% of patients with severe ARDS received prone position. Overall hospital mortality was 34.0%. Hospital mortality was 21.8% for mild, 31.1% for moderate, and 60.0% for patients with severe ARDS (P=0.004).
Despite general acceptance of low Vt and limited Pplat, high driving pressure, low PEEP and low use of adjunctive measures may still be a concern in mainland China, especially in patients with severe ARDS.
ClinicalTrials.gov NCT01666834; date of registration release: August 14
2012.</description><identifier>ISSN: 2072-1439</identifier><identifier>EISSN: 2072-1439</identifier><identifier>EISSN: 2077-6624</identifier><identifier>DOI: 10.21037/jtd.2018.08.137</identifier><identifier>PMID: 30416787</identifier><language>eng</language><publisher>China: AME Publishing Company</publisher><subject>Original</subject><ispartof>Journal of thoracic disease, 2018-09, Vol.10 (9), p.5394-5404</ispartof><rights>2018 Journal of Thoracic Disease. All rights reserved. 2018 Journal of Thoracic Disease.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-6901c7da7b70b5ed5fdab1f55f33ff0fb585bf414db0d7c582ec4931aefae7233</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196194/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196194/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30416787$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Ling</creatorcontrib><creatorcontrib>Yang, Yi</creatorcontrib><creatorcontrib>Gao, Zhiwei</creatorcontrib><creatorcontrib>Li, Maoqin</creatorcontrib><creatorcontrib>Mu, Xinwei</creatorcontrib><creatorcontrib>Ma, Xiaochun</creatorcontrib><creatorcontrib>Li, Guicheng</creatorcontrib><creatorcontrib>Sun, Wen</creatorcontrib><creatorcontrib>Wang, Xue</creatorcontrib><creatorcontrib>Gu, Qin</creatorcontrib><creatorcontrib>Zheng, Ruiqiang</creatorcontrib><creatorcontrib>Zhao, Hongsheng</creatorcontrib><creatorcontrib>Ao, Dan</creatorcontrib><creatorcontrib>Yu, Wenkui</creatorcontrib><creatorcontrib>Wang, Yushan</creatorcontrib><creatorcontrib>Chen, Kang</creatorcontrib><creatorcontrib>Yan, Jie</creatorcontrib><creatorcontrib>Li, Jianguo</creatorcontrib><creatorcontrib>Cai, Guolong</creatorcontrib><creatorcontrib>Wang, Yurong</creatorcontrib><creatorcontrib>Wang, Hongliang</creatorcontrib><creatorcontrib>Kang, Yan</creatorcontrib><creatorcontrib>Slutsky, Arthur S</creatorcontrib><creatorcontrib>Liu, Songqiao</creatorcontrib><creatorcontrib>Xie, Jianfen</creatorcontrib><creatorcontrib>Qiu, Haibo</creatorcontrib><title>Practice of diagnosis and management of acute respiratory distress syndrome in mainland China: a cross-sectional study</title><title>Journal of thoracic disease</title><addtitle>J Thorac Dis</addtitle><description>Although acute respiratory distress syndrome (ARDS) has been recognized for more than 50 years, limited information exists about the incidence and management of ARDS in mainland China. To evaluate the potential for improvement in management of patients with ARDS, this study was designed to describe the incidence and management of ARDS in mainland China.
National prospective multicenter observational study over one month (August 31
to September 30
, 2012) of all patients who fulfilled the Berlin or American European Consensus Conference (AECC) definition of ARDS in 20 intensive care units, with data collection related to the management of ARDS, patient characteristics and outcomes.
Of the 1,814 patients admitted during the enrollment period, 149 (8.2%) and 147 (8.1%) patients were diagnosed by AECC and Berlin definition, respectively. Lung protective strategy with low tidal volume (Vt) (≤8 mL/kg) and limitation of the plateau pressure (Pplat) (≤30 cmH
O) was performed in 75.2% patients. And, 36%, 21.1% and 4.1% patients with severe, moderate and mild ARDS had the driving pressure more than 14 cmH
O (P<0.05). Pplat and driving pressure increased significantly in patients with a higher degree of ARDS severity (P=0.002 and P<0.001, respectively), but Vt were comparable in the three groups (P>0.05). In severe ARDS, patient median positive end expiratory pressure (PEEP) was 10.0 (8.0-11.3) cmH
O and median FiO
was 90%. A recruitment maneuver was performed in 35.5% of the patients, and 8.7% of patients with severe ARDS received prone position. Overall hospital mortality was 34.0%. Hospital mortality was 21.8% for mild, 31.1% for moderate, and 60.0% for patients with severe ARDS (P=0.004).
Despite general acceptance of low Vt and limited Pplat, high driving pressure, low PEEP and low use of adjunctive measures may still be a concern in mainland China, especially in patients with severe ARDS.
ClinicalTrials.gov NCT01666834; date of registration release: August 14
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To evaluate the potential for improvement in management of patients with ARDS, this study was designed to describe the incidence and management of ARDS in mainland China.
National prospective multicenter observational study over one month (August 31
to September 30
, 2012) of all patients who fulfilled the Berlin or American European Consensus Conference (AECC) definition of ARDS in 20 intensive care units, with data collection related to the management of ARDS, patient characteristics and outcomes.
Of the 1,814 patients admitted during the enrollment period, 149 (8.2%) and 147 (8.1%) patients were diagnosed by AECC and Berlin definition, respectively. Lung protective strategy with low tidal volume (Vt) (≤8 mL/kg) and limitation of the plateau pressure (Pplat) (≤30 cmH
O) was performed in 75.2% patients. And, 36%, 21.1% and 4.1% patients with severe, moderate and mild ARDS had the driving pressure more than 14 cmH
O (P<0.05). Pplat and driving pressure increased significantly in patients with a higher degree of ARDS severity (P=0.002 and P<0.001, respectively), but Vt were comparable in the three groups (P>0.05). In severe ARDS, patient median positive end expiratory pressure (PEEP) was 10.0 (8.0-11.3) cmH
O and median FiO
was 90%. A recruitment maneuver was performed in 35.5% of the patients, and 8.7% of patients with severe ARDS received prone position. Overall hospital mortality was 34.0%. Hospital mortality was 21.8% for mild, 31.1% for moderate, and 60.0% for patients with severe ARDS (P=0.004).
Despite general acceptance of low Vt and limited Pplat, high driving pressure, low PEEP and low use of adjunctive measures may still be a concern in mainland China, especially in patients with severe ARDS.
ClinicalTrials.gov NCT01666834; date of registration release: August 14
2012.</abstract><cop>China</cop><pub>AME Publishing Company</pub><pmid>30416787</pmid><doi>10.21037/jtd.2018.08.137</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| title | Practice of diagnosis and management of acute respiratory distress syndrome in mainland China: a cross-sectional study |
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