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Prevalence and outcomes of acute hypoxaemic respiratory failure in Wales: The PANDORA-WALES Study

Kopczynska, Maja, Sharif, Ben, Pugh, Richard, Otahal, Igor, Havalda, Peter, Groblewski, Wojciech, Lynch, Ceri, George, David, Sutherland, Jayne, Pandey, Manish, Jones, Phillippa, Murdoch, Maxene, Hatalyak, Adam, Jones, Rhidian, Kacmarek, Robert, Villar, Jesús, Szakmany, Tamas and on behalf of the PANDORA-WALES Investigators, 2020. Prevalence and outcomes of acute hypoxaemic respiratory failure in Wales: The PANDORA-WALES Study. Journal of Clinical Medicine 9 (11) , 3521. 10.3390/jcm9113521

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Abstract

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.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Additional Information: This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/)
Publisher: MDPI
ISSN: 2077-0383
Date of First Compliant Deposit: 19 May 2021
Date of Acceptance: 29 October 2020
Last Modified: 21 May 2021 10:45
URI: http://orca.cardiff.ac.uk/id/eprint/141465

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