Prevalence and Outcomes of Acute Hypoxaemic Respiratory Failure in Wales: The PANDORA-WALES Study
Background: We aimed to identify the prevalence of acute hypoxaemic respiratory failure (AHRF) in the intensive care unit (ICU) and its associated mortality. The secondary aim was to describe ventilatory management as well as the use of rescue therapies. Methods: Multi-centre prospective study in ni...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/11/3521 |
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| author | Maja Kopczynska Ben Sharif Richard Pugh Igor Otahal Peter Havalda Wojciech Groblewski Ceri Lynch David George Jayne Sutherland Manish Pandey Phillippa Jones Maxene Murdoch Adam Hatalyak Rhidian Jones Robert M. Kacmarek Jesús Villar Tamas Szakmany on behalf of the PANDORA-WALES Investigators |
| author_facet | Maja Kopczynska Ben Sharif Richard Pugh Igor Otahal Peter Havalda Wojciech Groblewski Ceri Lynch David George Jayne Sutherland Manish Pandey Phillippa Jones Maxene Murdoch Adam Hatalyak Rhidian Jones Robert M. Kacmarek Jesús Villar Tamas Szakmany on behalf of the PANDORA-WALES Investigators |
| author_sort | Maja Kopczynska |
| collection | DOAJ |
| description | Background: We aimed to identify the prevalence of acute hypoxaemic respiratory failure (AHRF) in the intensive care unit (ICU) and its associated mortality. The secondary aim was to describe ventilatory management as well as the use of rescue therapies. Methods: Multi-centre prospective study in nine hospitals in Wales, UK, over 2-month periods. All patients admitted to an ICU were screened for AHRF and followed-up until discharge from the ICU. Data were collected from patient charts on patient demographics, clinical characteristics, management and outcomes. Results: Out of 2215 critical care admissions, 886 patients received mechanical ventilation. A total of 197 patients met inclusion criteria and were recruited. Seventy (35.5%) were non-survivors. Non-survivors were significantly older, had higher SOFA scores and received more vasopressor support than survivors. Twenty-five (12.7%) patients who fulfilled the Berlin definition of acute respiratory distress syndrome (ARDS) during the ICU stay without impact on overall survival. Rescue therapies were rarely used. Analysis of ventilation showed that median Vt was 7.1 mL/kg PBW (IQR 5.9–9.1) and 21.3% of patients had optimal ventilation during their ICU stay. Conclusions: One in four mechanically ventilated patients have AHRF. Despite advances of care and better, but not optimal, utilisation of low tidal volume ventilation, mortality remains high. |
| first_indexed | 2024-03-10T15:10:33Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T15:10:33Z |
| publishDate | 2020-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-ff6bdb95f5ea43e6a6fd597d45a04b9f2023-11-20T19:23:05ZengMDPI AGJournal of Clinical Medicine2077-03832020-10-01911352110.3390/jcm9113521Prevalence and Outcomes of Acute Hypoxaemic Respiratory Failure in Wales: The PANDORA-WALES StudyMaja Kopczynska0Ben Sharif1Richard Pugh2Igor Otahal3Peter Havalda4Wojciech Groblewski5Ceri Lynch6David George7Jayne Sutherland8Manish Pandey9Phillippa Jones10Maxene Murdoch11Adam Hatalyak12Rhidian Jones13Robert M. Kacmarek14Jesús Villar15Tamas Szakmany16on behalf of the PANDORA-WALES InvestigatorsDepartment of Anaesthesia, Intensive Care and Pain Medicine, Division of Population Medicine, Heath Park Campus, Cardiff University, Cardiff CF14 4XN, UKDepartment of Anaesthesia, Intensive Care and Pain Medicine, Division of Population Medicine, Heath Park Campus, Cardiff University, Cardiff CF14 4XN, UKAnaesthetic Department, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Bodelwyddan, Rhyl LL18 5UJ, UKAnaesthetic Department, Glangwili Hospital, Hywel Dda University Health Board, Carmarthen SA31 2AF, UKAnaesthetic Department, Glangwili Hospital, Hywel Dda University Health Board, Carmarthen SA31 2AF, UKAnaesthetic Department, Withybush Hospital, Hywel Dda University Health Board, Haverfordwest SA61 2PZ, UKAnaesthetic Department, Royal Glamorgan Hospital, Cwm Taf Morgannwg University Health Board, Llantrisant CF72 8XR, UKAnaesthetic Department, Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board, Wrexham LL13 7TD, UKEd Major Critical Care Unit, Morriston Hospital, Swansea Bay, University Health Board, Swansea SA6 6NL, UKCritical Care Department, University Hospital Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UKCritical Care Directorate, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, Gwent NP20 2UB, UKCritical Care Directorate, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, Gwent NP20 2UB, UKCritical Care Directorate, Nevill Hall Hospital, Aneurin Bevan University Health Board, Abergavenny NP7 7EG, UKAnaesthetic Department, Princess of Wales Hospital, Cwm Taf Morgannwg University Health Board, Bridgend CF31 1RQ, UKDepartment of Respiratory Care, Massachusetts General Hospital, Boston, MA 02114, USACIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, 28029 Madrid, SpainDepartment of Anaesthesia, Intensive Care and Pain Medicine, Division of Population Medicine, Heath Park Campus, Cardiff University, Cardiff CF14 4XN, UKBackground: We aimed to identify the prevalence of acute hypoxaemic respiratory failure (AHRF) in the intensive care unit (ICU) and its associated mortality. The secondary aim was to describe ventilatory management as well as the use of rescue therapies. Methods: Multi-centre prospective study in nine hospitals in Wales, UK, over 2-month periods. All patients admitted to an ICU were screened for AHRF and followed-up until discharge from the ICU. Data were collected from patient charts on patient demographics, clinical characteristics, management and outcomes. Results: Out of 2215 critical care admissions, 886 patients received mechanical ventilation. A total of 197 patients met inclusion criteria and were recruited. Seventy (35.5%) were non-survivors. Non-survivors were significantly older, had higher SOFA scores and received more vasopressor support than survivors. Twenty-five (12.7%) patients who fulfilled the Berlin definition of acute respiratory distress syndrome (ARDS) during the ICU stay without impact on overall survival. Rescue therapies were rarely used. Analysis of ventilation showed that median Vt was 7.1 mL/kg PBW (IQR 5.9–9.1) and 21.3% of patients had optimal ventilation during their ICU stay. Conclusions: One in four mechanically ventilated patients have AHRF. Despite advances of care and better, but not optimal, utilisation of low tidal volume ventilation, mortality remains high.https://www.mdpi.com/2077-0383/9/11/3521respiratory failureventilationrescue therapiessurvival |
| spellingShingle | Maja Kopczynska Ben Sharif Richard Pugh Igor Otahal Peter Havalda Wojciech Groblewski Ceri Lynch David George Jayne Sutherland Manish Pandey Phillippa Jones Maxene Murdoch Adam Hatalyak Rhidian Jones Robert M. Kacmarek Jesús Villar Tamas Szakmany on behalf of the PANDORA-WALES Investigators Prevalence and Outcomes of Acute Hypoxaemic Respiratory Failure in Wales: The PANDORA-WALES Study Journal of Clinical Medicine respiratory failure ventilation rescue therapies survival |
| title | Prevalence and Outcomes of Acute Hypoxaemic Respiratory Failure in Wales: The PANDORA-WALES Study |
| title_full | Prevalence and Outcomes of Acute Hypoxaemic Respiratory Failure in Wales: The PANDORA-WALES Study |
| title_fullStr | Prevalence and Outcomes of Acute Hypoxaemic Respiratory Failure in Wales: The PANDORA-WALES Study |
| title_full_unstemmed | Prevalence and Outcomes of Acute Hypoxaemic Respiratory Failure in Wales: The PANDORA-WALES Study |
| title_short | Prevalence and Outcomes of Acute Hypoxaemic Respiratory Failure in Wales: The PANDORA-WALES Study |
| title_sort | prevalence and outcomes of acute hypoxaemic respiratory failure in wales the pandora wales study |
| topic | respiratory failure ventilation rescue therapies survival |
| url | https://www.mdpi.com/2077-0383/9/11/3521 |
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