Driving pressure and long-term outcomes in moderate/severe acute respiratory distress syndrome
Abstract Background Acute respiratory distress syndrome (ARDS) patients may present impaired in lung function and structure after hospital discharge that may be related to mechanical ventilation strategy. The aim of this study was to evaluate the association between functional and structural lung im...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2018-12-01
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| Series: | Annals of Intensive Care |
| Online Access: | http://link.springer.com/article/10.1186/s13613-018-0469-4 |
| _version_ | 1818292892727246848 |
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| author | Carlos Toufen Junior Roberta R. De Santis Santiago Adriana S. Hirota Alysson Roncally S. Carvalho Susimeire Gomes Marcelo Brito Passos Amato Carlos Roberto Ribeiro Carvalho |
| author_facet | Carlos Toufen Junior Roberta R. De Santis Santiago Adriana S. Hirota Alysson Roncally S. Carvalho Susimeire Gomes Marcelo Brito Passos Amato Carlos Roberto Ribeiro Carvalho |
| author_sort | Carlos Toufen Junior |
| collection | DOAJ |
| description | Abstract Background Acute respiratory distress syndrome (ARDS) patients may present impaired in lung function and structure after hospital discharge that may be related to mechanical ventilation strategy. The aim of this study was to evaluate the association between functional and structural lung impairment, N-terminal-peptide type III procollagen (NT-PCP-III) and driving pressure during protective mechanical ventilation. It was a secondary analysis of data from randomized controlled trial that included patients with moderate/severe ARDS with at least one follow-up visit performed. We obtained serial measurements of plasma NT-PCP-III levels. Whole-lung computed tomography analysis and pulmonary function test were performed at 1 and 6 months of follow-up. A health-related quality of life survey after 6 months was also performed. Results Thirty-three patients were enrolled, and 21 patients survived after 6 months. In extubation day an association between driving pressure and NT-PCP-III was observed. At 1 and 6 months forced vital capacity (FVC) was negatively correlated to driving pressure (p < 0.01). At 6 months driving pressure was associated with lower FVC independently on tidal volume, plateau pressure and baseline static respiratory compliance after adjustments (r 2 = 0.51, p = 0.02). There was a significant correlation between driving pressure and lung densities and nonaerated/poorly aerated lung volume after 6 months. Driving pressure was also related to general health domain of SF-36 at 6 months. Conclusion Even in patients ventilated with protective tidal volume, higher driving pressure is associated with worse long-term pulmonary function and structure. |
| first_indexed | 2024-12-13T03:07:11Z |
| format | Article |
| id | doaj.art-e228b548ab0a40348b0d9962f415429e |
| institution | Directory Open Access Journal |
| issn | 2110-5820 |
| language | English |
| last_indexed | 2024-12-13T03:07:11Z |
| publishDate | 2018-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj.art-e228b548ab0a40348b0d9962f415429e2022-12-22T00:01:41ZengSpringerOpenAnnals of Intensive Care2110-58202018-12-018111010.1186/s13613-018-0469-4Driving pressure and long-term outcomes in moderate/severe acute respiratory distress syndromeCarlos Toufen Junior0Roberta R. De Santis Santiago1Adriana S. Hirota2Alysson Roncally S. Carvalho3Susimeire Gomes4Marcelo Brito Passos Amato5Carlos Roberto Ribeiro Carvalho6Divisão de Pneumologia, Cardiopulmonary Department, Heart Institute (InCor) University of São PauloDivisão de Pneumologia, Cardiopulmonary Department, Heart Institute (InCor) University of São PauloDivisão de Pneumologia, Cardiopulmonary Department, Heart Institute (InCor) University of São PauloLaboratory of Pulmonary Engineering, Biomedical Engineering Program, Alberto Luiz Coimbra Institute of Post-Graduation and Research in Engineering, Federal University of Rio de JaneiroDivisão de Pneumologia, Cardiopulmonary Department, Heart Institute (InCor) University of São PauloRespiratory Intensive Care Unit, University of São Paulo School of Medicine Hospital das ClínicasDivisão de Pneumologia, Cardiopulmonary Department, Heart Institute (InCor) University of São PauloAbstract Background Acute respiratory distress syndrome (ARDS) patients may present impaired in lung function and structure after hospital discharge that may be related to mechanical ventilation strategy. The aim of this study was to evaluate the association between functional and structural lung impairment, N-terminal-peptide type III procollagen (NT-PCP-III) and driving pressure during protective mechanical ventilation. It was a secondary analysis of data from randomized controlled trial that included patients with moderate/severe ARDS with at least one follow-up visit performed. We obtained serial measurements of plasma NT-PCP-III levels. Whole-lung computed tomography analysis and pulmonary function test were performed at 1 and 6 months of follow-up. A health-related quality of life survey after 6 months was also performed. Results Thirty-three patients were enrolled, and 21 patients survived after 6 months. In extubation day an association between driving pressure and NT-PCP-III was observed. At 1 and 6 months forced vital capacity (FVC) was negatively correlated to driving pressure (p < 0.01). At 6 months driving pressure was associated with lower FVC independently on tidal volume, plateau pressure and baseline static respiratory compliance after adjustments (r 2 = 0.51, p = 0.02). There was a significant correlation between driving pressure and lung densities and nonaerated/poorly aerated lung volume after 6 months. Driving pressure was also related to general health domain of SF-36 at 6 months. Conclusion Even in patients ventilated with protective tidal volume, higher driving pressure is associated with worse long-term pulmonary function and structure.http://link.springer.com/article/10.1186/s13613-018-0469-4 |
| spellingShingle | Carlos Toufen Junior Roberta R. De Santis Santiago Adriana S. Hirota Alysson Roncally S. Carvalho Susimeire Gomes Marcelo Brito Passos Amato Carlos Roberto Ribeiro Carvalho Driving pressure and long-term outcomes in moderate/severe acute respiratory distress syndrome Annals of Intensive Care |
| title | Driving pressure and long-term outcomes in moderate/severe acute respiratory distress syndrome |
| title_full | Driving pressure and long-term outcomes in moderate/severe acute respiratory distress syndrome |
| title_fullStr | Driving pressure and long-term outcomes in moderate/severe acute respiratory distress syndrome |
| title_full_unstemmed | Driving pressure and long-term outcomes in moderate/severe acute respiratory distress syndrome |
| title_short | Driving pressure and long-term outcomes in moderate/severe acute respiratory distress syndrome |
| title_sort | driving pressure and long term outcomes in moderate severe acute respiratory distress syndrome |
| url | http://link.springer.com/article/10.1186/s13613-018-0469-4 |
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