Academic Journal
Impact of Arterial CO(2) Retention in Patients With Moderate or Severe ARDS
| العنوان: | Impact of Arterial CO(2) Retention in Patients With Moderate or Severe ARDS |
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| المؤلفون: | Maamar, Adel, Delamaire, Flora, Reizine, Florian, Lesouhaitier, Mathieu, Painvin, Benoit, Quelven, Quentin, Coirier, Valentin, Guillot, Pauline, Le Tulzo, Yves, Tadie, Jean Marc, Gacouin, Arnaud |
| المساهمون: | Centre Hospitalier Universitaire Rennes, Université de Rennes - Faculté de Médecine (UR Médecine), Université de Rennes (UR), Centre d'Investigation Clinique Rennes (CIC), Université de Rennes (UR)-Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Ponchaillou -Institut National de la Santé et de la Recherche Médicale (INSERM), None |
| المصدر: | ISSN: 0020-1324. |
| بيانات النشر: | HAL CCSD Daedalus Enterprises Inc |
| سنة النشر: | 2023 |
| المجموعة: | Université de Rennes 1: Publications scientifiques (HAL) |
| مصطلحات موضوعية: | ARDS, cohort study, hypercapnia, mortality, [SDV]Life Sciences [q-bio], [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract |
| الوصف: | International audience ; BACKGROUND: Lung-protective ventilation (reduced tidal volume and limited plateau pressure) may lead to CO(2) retention. Data about the impact of hypercapnia in patients with ARDS are scarce and conflicting. METHODS: We performed a non-interventional cohort study with subjects with ARDS admitted from 2006 to 2021 and with P(aO(2)) /F(IO(2)) ≤ 150 mm Hg. We examined the association between severe hypercapnia (P(aCO(2)) ≥ 50 mm Hg) on the first 5 days after the diagnosis of ARDS and death in ICU for 930 subjects. All the subjects received lung-protective ventilation. RESULTS: Severe hypercapnia was noted in 552 subjects (59%) on the first day of ARDS (day 1); 323/930 (34.7%) died in the ICU. Severe hypercapnia on day 1 was associated with mortality in the unadjusted (odds ratio 1.54, 95% CI 1.16-1.63; P = .003) and adjusted (odds ratio 1.47, 95% CI 1.08-2.43; P = .004) models. In the Bayesian analysis, the posterior probability that severe hypercapnia was associated with ICU death was > 90% in 4 different priors, including a septic prior for this association. Sustained severe hypercapnia on day 5, defined as severe hypercapnia present from day 1 to day 5, was noted in 93 subjects (12%). After propensity score matching, severe hypercapnia on day 5 remained associated with ICU mortality (odds ratio 1.73, 95% CI 1.02-2.97; P = .047). CONCLUSIONS: Severe hypercapnia was associated with mortality in subjects with ARDS who received lung-protective ventilation. Our results deserve further evaluation of the strategies and treatments that aim to control CO(2) retention. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/36977590; hal-04061274; https://hal.science/hal-04061274; https://hal.science/hal-04061274/document; https://hal.science/hal-04061274/file/Maamar%20et%20al%20-%202023%20-%20Impact%20of%20Arterial%20CO2%20Retention%20in%20Patients%20With%20Moderate%20or%20Severe%20ARDS%20_%20RC-10507.R1_Proof_hi.pdf; PUBMED: 36977590; PUBMEDCENTRAL: PMC10171350 |
| DOI: | 10.4187/respcare.10507 |
| الاتاحة: | https://hal.science/hal-04061274 https://hal.science/hal-04061274/document https://hal.science/hal-04061274/file/Maamar%20et%20al%20-%202023%20-%20Impact%20of%20Arterial%20CO2%20Retention%20in%20Patients%20With%20Moderate%20or%20Severe%20ARDS%20_%20RC-10507.R1_Proof_hi.pdf https://doi.org/10.4187/respcare.10507 |
| Rights: | http://creativecommons.org/licenses/by-nc/ ; info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.52D6C385 |
| قاعدة البيانات: | BASE |
| DOI: | 10.4187/respcare.10507 |
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