tailieunhanh - Báo cáo y học: " Decreased respiratory system compliance on the sixth day of mechanical ventilation is a predictor of death in patients with established acute lung injury"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học 'Respiratory Research cung cấp cho các bạn kiến thức về ngành y đề tài:Decreased respiratory system compliance on the sixth day of mechanical ventilation is a predictor of death in patients with established acute lung injury. | Seeley et al. Respiratory Research 2011 12 52 http content 12 1 52 RESPIRATORY RESEARCH RESEARCH Open Access Decreased respiratory system compliance on the sixth day of mechanical ventilation is a predictor of death in patients with established acute lung injury 1 2 1 3 1 1 Eric J Seeley Daniel F McAuley Mark Eisner Michael Miletin HanJing Zhuo Michael A Matthay and Richard H Kallet4 Abstract Background Multiple studies have identified single variables or composite scores that help risk stratify patients at the time of acute lung injury ALI diagnosis. However few studies have addressed the important question of how changes in pulmonary physiologic variables might predict mortality in patients during the subacute or chronic phases of ALI. We studied pulmonary physiologic variables including respiratory system compliance P F ratio and oxygenation index in a cohort of patients with ALI who survived more than 6 days of mechanical ventilation to see if changes in these variables were predictive of death and whether they are informative about the pathophysiology of subacute ALI. Methods Ninety-three patients with ALI who were mechanically ventilated for more than 6 days were enrolled in this prospective cohort study. Patients were enrolled at two medical centers in the US a county hospital and a large academic center. Bivariate analyses were used to identify pulmonary physiologic predictors of death during the first 6 days of mechanical ventilation. Predictors on day 1 day 6 and the changes between day 1 and day 6 were compared in a multivariate logistic regression model. Results The overall mortality was 35 . In multivariate analysis the PaO2 FiO2 OR p and respiratory system compliance OR p were predictive of death on the 6th day of acute lung injury. In addition a decrease in respiratory system compliance between days 1 and days 6 OR p was independently associated with mortality. Conclusions A low respiratory .

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