Impact of Lung Compliance on Neurological Outcome in Patients with Acute Respiratory Distress Syndrome Following Out-of-Hospital Cardiac Arrest

Kim, June-Sung; Kim, Youn-Jung; Kim, Muyeol; Ryoo, Seung Mok; Sohn, Chang Hwan; Kim, Won Young

doi:10.3390/jcm9020527

Cited by 13 publications

(9 citation statements)

References 30 publications

(38 reference statements)

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“…Although the lung compliance was similar at the time of intubation, survivors showed gradual improvement in lung compliance, while non-survivors showed persistently low lung compliance. This is consistent with other studies that lung compliance was an independent predictor of mortality ( 5 , 23 , 24 ). An important finding in our study was that RM was not effective in improving lung compliance, which is in contrast to findings from general ARDS patients.…”

Section: Discussionsupporting

confidence: 93%

Lung Mechanics of Mechanically Ventilated Patients With COVID-19: Analytics With High-Granularity Ventilator Waveform Data

Pan

Zhou

et al. 2020

Front. Med.

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Background: Lung mechanics during invasive mechanical ventilation (IMV) for both prognostic and therapeutic implications; however, the full trajectory lung mechanics has never been described for novel coronavirus disease 2019 (COVID-19) patients requiring IMV. The study aimed to describe the full trajectory of lung mechanics of mechanically ventilated COVID-19 patients. The clinical and ventilator setting that can influence patient-ventilator asynchrony (PVA) and compliance were explored. Post-extubation spirometry test was performed to assess the pulmonary function after COVID-19 induced ARDS. Methods: This was a retrospective study conducted in a tertiary care hospital. All patients with IMV due to COVID-19 induced ARDS were included. High-granularity ventilator waveforms were analyzed with deep learning algorithm to obtain PVAs. Asynchrony index (AI) was calculated as the number of asynchronous events divided by the number of ventilator cycles and wasted efforts. Mortality was recorded as the vital status on hospital discharge. Results: A total of 3,923,450 respiratory cycles in 2,778 h were analyzed (average: 24 cycles/min) for seven patients. Higher plateau pressure (Coefficient: −0.90; 95% CI: −1.02 to −0.78) and neuromuscular blockades (Coefficient: −6.54; 95% CI: −9.92 to −3.16) were associated with lower AI. Survivors showed increasing compliance over time, whereas non-survivors showed persistently low compliance. Recruitment maneuver was not able to improve lung compliance. Patients were on supine position in 1,422 h (51%), followed by prone positioning (499 h, 18%), left positioning (453 h, 16%), and right positioning (404 h, 15%). As compared with supine positioning, prone positioning was associated with 2.31 ml/cmH 2 O (95% CI: 1.75 to 2.86; p < 0.001) increase in lung compliance. Spirometry tests showed that pulmonary functions were reduced to one third of the predicted values after extubation. Ge et al. Lung Mechanics in COVID-19 Conclusions: The study for the first time described full trajectory of lung mechanics of patients with COVID-19. The result showed that prone positioning was associated with improved compliance; higher plateau pressure and use of neuromuscular blockades were associated with lower risk of AI.

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Section: Discussionsupporting

confidence: 93%

Lung Mechanics of Mechanically Ventilated Patients With COVID-19: Analytics With High-Granularity Ventilator Waveform Data

Pan

Zhou

et al. 2020

Front. Med.

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“…9,90,91 Acute respiratory distress syndrome is not uncommon in cardiac arrest patients and is associated with worse outcomes. 9,92,93 Low lung compliance predicts poor functional outcome in OHCA patients 94 ; however, ventilation with lower tidal volumes is not standard practice in neurointensive care. 95 Two pilot studies have compared different carbon dioxide targets during post resuscitation care.…”

Section: Control Of Ventilationmentioning

confidence: 99%

European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2021: Post-resuscitation care

et al. 2021

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The European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) have collaborated to produce these postresuscitation care guidelines for adults, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include the post-cardiac arrest syndrome, diagnosis of cause of cardiac arrest, control of oxygenation and ventilation, coronary reperfusion, haemodynamic monitoring and management, control of seizures, temperature control, general intensive care management, prognostication, long-term outcome, rehabilitation, and organ donation.

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“…The in-hospital mortality rate of ARDS patients remains between 34 and 60% ( 3 ). At present, the treatment of ARDS predominantly includes mechanical ventilation therapy ( 4 ). Therefore, identification of novel and effective treatment strategies is crucial for patients with ARDS.…”

Section: Introductionmentioning

confidence: 99%

A Simple-to-Use Web-Based Calculator for Survival Prediction in Acute Respiratory Distress Syndrome

Liu

Huang

2021

Front. Med.

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Background: The aim of this study was to construct and validate a simple-to-use model to predict the survival of patients with acute respiratory distress syndrome.Methods: A total of 197 patients with acute respiratory distress syndrome were selected from the Dryad Digital Repository. All eligible individuals were randomly stratified into the training set (n=133) and the validation set (n=64) as 2: 1 ratio. LASSO regression analysis was used to select the optimal predictors, and receiver operating characteristic and calibration curves were used to evaluate accuracy and discrimination of the model. Clinical usefulness of the model was also assessed using decision curve analysis and Kaplan-Meier analysis.Results: Age, albumin, platelet count, PaO2/FiO2, lactate dehydrogenase, high-resolution computed tomography score, and etiology were identified as independent prognostic factors based on LASSO regression analysis; these factors were integrated for the construction of the nomogram. Results of calibration plots, decision curve analysis, and receiver operating characteristic analysis showed that this model has good predictive ability of patient survival in acute respiratory distress syndrome. Moreover, a significant difference in the 28-day survival was shown between the patients stratified into different risk groups (P < 0.001). For convenient application, we also established a web-based calculator (https://huangl.shinyapps.io/ARDSprognosis/).Conclusions: We satisfactorily constructed a simple-to-use model based on seven relevant factors to predict survival and prognosis of patients with acute respiratory distress syndrome. This model can aid personalized treatment and clinical decision-making.

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Impact of Lung Compliance on Neurological Outcome in Patients with Acute Respiratory Distress Syndrome Following Out-of-Hospital Cardiac Arrest

Cited by 13 publications

References 30 publications

Lung Mechanics of Mechanically Ventilated Patients With COVID-19: Analytics With High-Granularity Ventilator Waveform Data

Lung Mechanics of Mechanically Ventilated Patients With COVID-19: Analytics With High-Granularity Ventilator Waveform Data

European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2021: Post-resuscitation care

A Simple-to-Use Web-Based Calculator for Survival Prediction in Acute Respiratory Distress Syndrome

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