The Epidemiology of Acute Respiratory Distress Syndrome in Patients Presenting to the Emergency Department With Severe Sepsis

Mikkelsen, Mark E.; Shah, Chirag V.; Meyer, Nuala J.; Gaieski, David F.; Lyon, Sarah; Miltiades, Andrea; Goyal, Munish; Fuchs, Barry D.; Bellamy, Scarlett; Christie, Jason D.

doi:10.1097/shk.0000000000000030

Cited by 19 publications

(26 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…14 Th is current investigation of a heterogeneous ED population demonstrated an ARDS prevalence of 6.8%, which is similar to the fi ndings of work examining ARDS in patients receiving mechanical ventilation in the ED. 14,17,18 Combining data from these studies provides some epidemiologic insight into an ED ARDS prevalence of approximately 8.4% in intubated patients. As in previous work, adherence to lung-protective ventilation in patients with ARDS was low (46.7%).…”

Section: Figure 3 -Hospital D 0 Refers To the Ed Incidence Of Ards Rmentioning

confidence: 99%

See 1 more Smart Citation

Mechanical Ventilation and ARDS in the ED

Fuller

Mohr

Miller

et al. 2015

Chest

View full text Add to dashboard Cite

show abstract

Section: Figure 3 -Hospital D 0 Refers To the Ed Incidence Of Ards Rmentioning

confidence: 99%

“…Observational studies indicate an ARDS prevalence of approximately 9% in patients receiving mechanical ventilation in the ED. 14,17,18 Most of these data, however, are restricted to a narrow cohort of patients (ie, those with sepsis) and are singlecenter investigations.…”

mentioning

confidence: 99%

Mechanical Ventilation and ARDS in the ED

Fuller

Mohr

Miller

et al. 2015

Chest

View full text Add to dashboard Cite

show abstract

“…Factors such as morbid obesity (BMI >40 kg/m 2 ), advanced age, and males were associated with prolonged IMV in post cardiac surgery patients [10–12]. Other factors associated with increased incidence of acute lung injury in sepsis include elevated lactate, delayed antibiotics, alcohol abuse, and diabetes mellitus [13,14]. The finding from our study of hospitalized sepsis patients shows similar predictors of IMV, and also helps stratify the risk based on different age groups.…”

Section: Discussionmentioning

confidence: 99%

Predictors and outcome of invasive mechanical ventilation in hospitalized patients with sepsis: data from National Inpatient Sample

Dhital

Basnet

Poudel

2018

Journal of Community Hospital Internal Medicine Perspectives

View full text Add to dashboard Cite

Background: Sepsis is a significant cause of mechanical ventilation in hospitalized patients.Objective: The aim of our study was to recognize the demographic and clinical characteristics associated with an increased need for invasive mechanical ventilation in hospitalized sepsis patients.Methods: We used National Inpatient Sample database from the years 2009–2011 to identify sepsis patients requiring invasive mechanical ventilation. We compared demographic and clinical characteristics of sepsis patients requiring and not requiring ventilator support and conducted univariate and multivariate analyses to determine odds ratio (OR) of association.Results: A total of 4,827,769 sepsis patients were identified among which 21.38% required invasive ventilation. Multivariate logistic regression [OR (95% CI), p<0.001] determined the following to be associated with increased odds of ventilator use: morbid obesity [1.37 (1.31–1.42)] and age group 35-64 years [1.18 (1.14–1.22)] compared to 18–34 years, whereas females [0.90 (0.88–0.91)] and age >85 years [0.49 (0.47–0.52)] had reduced odds of invasive ventilation. Hyperkalemia [1.12 (1.09–1.16)] and hypernatremia [2.26 (2.16–2.36)] were associated with increased odds while hypokalemia [0.94 (0.91–0.97)] had reduced odds of invasive ventilation. Septic patients requiring IMV had higher length of stay by 9.72 ± 0.17 days, hospitalization cost by US $ 43010.31 ± 988.24 and in-hospital mortality (41.33% vs 8.91%). Conclusion: Sepsis is a major cause of intensive care unit admission and initiation of invasive ventilation. Baseline demographic and clinical features affect the need for invasive ventilation. A clear understanding of these risk factors is integral for an appropriate and timely management.

show abstract

“…Lactate production is a protective response to allow cellular energy production to continue when tissue oxygen supply is inadequate for aerobic metabolism (Suetrong and Walley, 2016). Serum lactate levels remain a strong, independent predictor of lung injury (Mikkelsen et al, 2013). Elevated lactate levels are highly associated with in-hospital mortality and can be used to stratify patient risk (Casserly et al, 2015).…”

Section: Physiologic Biomarkersmentioning

confidence: 99%

Could Biomarkers Direct Therapy for the Septic Patient?

Sims

Nguyen

Mayeux

2016

Journal of Pharmacology and Experimental Therapeutics

View full text Add to dashboard Cite

Sepsis is a serious medical condition caused by a severe systemic inflammatory response to a bacterial, fungal, or viral infection that most commonly affects neonates and the elderly. Advances in understanding the pathophysiology of sepsis have resulted in guidelines for care that have helped reduce the risk of dying from sepsis for both children and older adults. Still, over the past three decades, a large number of clinical trials have been undertaken to evaluate pharmacological agents for sepsis. Unfortunately, all of these trials have failed, with the use of some agents even shown to be harmful. One key issue in these trials was the heterogeneity of the patient population that participated. What has emerged is the need to target therapeutic interventions to the specific patient's underlying pathophysiological processes, rather than looking for a universal therapy that would be effective in a "typical" septic patient, who does not exist. This review supports the concept that identification of the right biomarkers that can direct therapy and provide timely feedback on its effectiveness will enable critical care physicians to decrease mortality of patients with sepsis and improve the quality of life of survivors.

show abstract

The Epidemiology of Acute Respiratory Distress Syndrome in Patients Presenting to the Emergency Department With Severe Sepsis

Cited by 19 publications

References 26 publications

Mechanical Ventilation and ARDS in the ED

Mechanical Ventilation and ARDS in the ED

Predictors and outcome of invasive mechanical ventilation in hospitalized patients with sepsis: data from National Inpatient Sample

Could Biomarkers Direct Therapy for the Septic Patient?

Contact Info

Product

Resources

About