8 research outputs found
Correction to Collaborators in Acknowledgments in: Decision-Making on Withholding or Withdrawing Life Support in the ICU: A Worldwide Perspective (Chest (2017) 152(2) (321–329), (S0012369217308206), (10.1016/j.chest.2017.04.176))
No full textThe authors have reported to CHEST that the collaborators from the ICON Investigators were omitted from the Acknowledgments in “Decision-Making on Withholding or Withdrawing Life Support in the ICU: A Worldwide Perspective” (Chest. 2017;152(2):321-329). The corrected Acknowledgments are as follows: ∗ICON Investigators: E. Tomas, E. Amisi Bibonge, B. Charra, M. Faroudy, L. Doedens, Z. Farina, D. Adler, C. Balkema, A. Kok, S. Alaya, H. Gharsallah, D. Muzha, A. Temelkov, G. Georgiev, G. Simeonov, G. Tsaryanski, S. Georgiev, A. Seliman, S. Vrankovic, Z. Vucicevic, I. Gornik, B. Barsic, I. Husedzinovic, P. Pavlik, J. Manak, E. Kieslichova, R. Turek, M. Fischer, R. Valkova, L. Dadak, P. Dostal, J. Malaska, R. Hajek, A. Židková, P. Lavicka, J. Starkopf, Z. Kheladze, M. Chkhaidze, V. Kaloiani, L. Medve, A. Sarkany, I. Kremer, Z. Marjanek, P. Tamasi, I. Krupnova, I. Vanags, V. Liguts, V. Pilvinis, S. Vosylius, G. Kekstas, M. Balciunas, J. Kolbusz, A. Kübler, B. Mielczarek, M. Mikaszewska-Sokolewicz, K. Kotfis, B. Tamowicz, W. Sulkowski, P. Smuszkiewicz, A. Pihowicz, E. Trejnowska, N. Hagau, D. Filipescu, G. Droc, M. Lupu, A. Nica, R. Stoica, D. Tomescu, D. Constantinescu, G. Valcoreanu Zbaganu, S. Adriana, V. Bagin, D. Belsky, S. Palyutin, S. Shlyapnikov, D. Bikkulova, A. Gritsan, G. Natalia, E. Makarenko, V. Kokhno, A. Tolkach, E. Kokarev, B. Belotserkovskiy, K. Zolotukhin, V. Kulabukhov, L. Soskic, I. Palibrk, R. Jankovic, B. Jovanovic, M. Pandurovic, V. Bumbasirevic, B. Uljarevic, M. Surbatovic, N. Ladjevic, G. Slobodianiuk, V. Sobona, A. Cikova, A. Gebhardtova, C. Jun, S. Yunbo, J. Dong, S. Feng, M. Duan, Y. Xu, X. Xue, T. Gao, X. Xing, X. Zhao, C. Li, G. Gengxihua, H. Tan, J. Xu, L. Jiang, Q, Tiehe, Q, Bingyu, Q, Shi, Z. Lv, L. Zhang, L. Jingtao, Z. Zhen, Z. Wang, T. Wang, L. Yuhong, Q, Zhai, Y. Chen, C. Wang, W. Jiang, W. Ruilan, Y. Chen, H. Xiaobo, H. Ge, T. Yan, C. Yuhui, J. Zhang, F. Jian-Hong, H. Zhu, F. Huo, Y. Wang, C. Li, M. Zhuang, Z. Ma, J. Sun, L. Liuqingyue, M. Yang, J. Meng, S. Ma, K. Lee, Y. Kang, L. Yu, Q, Peng, Y. Wei, W. Zhang, R. Sun, A. Yeung, W. Wan, K. Sin, M. Wijanti, U. Widodo, H. Samsirun, T. Sugiman, C. Wisudarti, T. Maskoen, N. Hata, Y. Kobe, Y. Shimomura, D. Miyazaki, S. Nunomiya, S. Uchino, N. Kitamura, K. Yamashita, S. Hashimoto, H. Fukushima, N. Nik Adib, L. Tai, B. Tony, R. Bigornia, R. Bigornia, R. Bigornia, J. Palo, S. Chatterjee, B. Tan, A. Kong, S. Goh, C. Lee, C. Pothirat, B. Khwannimit, P. Theerawit, P. Pornsuriyasak, A. Piriyapatsom, A. Mukhtar, A. Nabil Hamdy, H. Hosny, A. Ashraf, M. Mokhtari, S. Nowruzinia, A. Lotfi, F. Zand, R. Nikandish, O. Moradi Moghaddam, J. Cohen, O. Sold, T. Sfeir, A. Hasan, D. Abugaber, H. Ahmad, T. Tantawy, S. Baharoom, H. Algethamy, A. Amr, G. Almekhlafi, R. Coskun, M. Sungur, A. Cosar, B. Güçyetmez, O. Demirkiran, E. Senturk, H. Ulusoy, H. Atalan, S. Serin, I. Kati, Z. Alnassrawi, A. Almemari, K. Krishnareddy, S. Kashef, A. Alsabbah, G. Poirier, J. Marshall, M. Herridge, M. Herridge, R. Fernandez, G. Fulda, S. Banschbach, J. Quintero, E. Schroeder, C. Sicoutris, R. Gueret, R. Kashyap, P. Bauer, R. Nanchal, R. Wunderink, E. Jimenez, A. Ryan, A. Ryan, A. Ryan, A. Ryan, A. Ryan, A. Ryan, A. Ryan, D. Prince, J. Edington, F. Van Haren, A. Bersten, B. Richards, M. Kilminster, D. Sturgess, M. Ziegenfuss, S. O'Connor, J. Lipman, L. Campbell, R. Mcallister, B. Roberts, P. Williams, R. Parke, P. Seigne, R. Freebairn, D. Nistor, C. Oxley, P. Young, R. Valentini, N. Wainsztein, P. Comignani, M. Casaretto, G. Sutton, P. Villegas, C. Galletti, J. Neira, D. Rovira, J. Hidalgo, F. Sandi, E. Caser, M. Thompson, M. D'agostino Dias, L. Fontes, M. Lunardi, N. Youssef, S. Lobo, R. Silva, J. Sales Jr, L. Madeira Campos Melo, M. Oliveira, M. Fonte, C. Grion, C. Feijo, V. Rezende, M. Assuncao, A. Neves, P. Gusman, D. Dalcomune, C. Teixeira, K. Kaefer, I. Maia, V. Souza Dantas, R. Costa Filho, F. Amorim, M. Assef, P. Schiavetto, J. Houly, J. Houly, F. Bianchi, F. Dias, C. Avila, J. Gomez, L. Rego, P. Castro, J. Passos, C. Mendes, C. Grion, G. Colozza Mecatti, M. Ferrreira, V. Irineu, M. Guerreiro, S. Ugarte, V. Tomicic, C. Godoy, W. Samaniego, I. Escamilla, I. Escamilla, L. Castro Castro, G. Libreros Duque, D. Diaz-Guio, F. Benítez, A. Guerra Urrego, R. Buitrago, G. Ortiz, M. Villalba Gaviria, D. Salas, J. Ramirez-Arce, E. Salgado, D. Morocho, J. Vergara, M. Chung Sang, C. Orellana-Jimenez, L. Garrido, O. Diaz, D. Resiere, C. Osorio, A. De La Vega, R. Carrillo, V. Sanchez, A. Villagomez, R. Martinez Zubieta, M. Sandia, M. Zalatiel, M. Poblano, D. Rodriguez Gonzalez, F. Arrazola, L. Juan Francisco, S. A. Ñamendys-Silva, M. Hernandez, D. Rodriguez Cadena, I. Lopez Islas, C. Ballesteros Zarzavilla, A. Matos, I. Oyanguren, J. Cerna, R. Quispe Sierra, R. Jimenez, L. Castillo, R. Ocal, A. Sencan, S. Mareque Gianoni, A. Deicas, J. Hurtado, G. Burghi, A. Martinelli, I. Von Der Osten, C. Du Maine, M. Bhattacharyya, S. Bandyopadhyay, S. Yanamala, P. Gopal, S. Sahu, M. Ibrahim, D. Rathod, N. Mukundan, A. Dewan, P. Amin, S. Samavedam, B. Shah, D. Gurupal, B. Lahkar, A. Mandal, M. Sircar, S. Ghosh, V. Balasubramani, F. Kapadia, S. Vadi, K. Nair, S. Tripathy, S. Nandakumar, J. Sharma, A. Kar, S. Jha, K. Zirpe Gurav, M. Patel, A. Bhavsar, D. Samaddar, A. Kulkarni, M. Hashmi, W. Ali, S. Nadeem, K. Indraratna, A. Margarit, P. Urbanek, J. Schlieber, J. Reisinger, J. Auer, A. Hartjes, A. Lerche, T. Janous, E. Kink, W. Krahulec, K. Smolle, M. Van Der Schueren, P. Thibo, M. Vanhoof, I. Ahmet, G. Philippe, P. Dufaye, O. Jacobs, V. Fraipont, P. Biston, A. Dive, Y. Bouckaert, E. Gilbert, B. Gressens, E. Pinck, V. Collin, J. L. Vincent, J. De Waele, R. Rimachi, D. Gusu, K. De Decker, K. Mandianga, L. Heytens, X. Wittebole, S. Herbert, V. Olivier, W. Vandenheede, P. Rogiers, P. Kolodzeike, M. Kruse, T. Andersen, V. Harjola, K. Saarinen, M. Leone, A. Durocher, S. Moulront, A. Lepape, M. Losser, P. Cabaret, E. Kalaitzis, E. Zogheib, P. Charve, B. Francois, J. Lefrant, B. Beilouny, X. Forceville, B. Misset, F. Jacobs, F. Bernard, D. Payen, A. Wynckel, V. Castelain, A. Faure, P. Lavagne, L. Thierry, M. Moussa, A. Vieillard-Baron, M. Durand, M. Gainnier, C. Ichai, S. Arens, C. Hoffmann, M. Kaffarnik, C. Scharnofske, I. Voigt, C. Peckelsen, M. Weber, J. Gille, A. Lange, G. Schoser, A. Sablotzki, U. Jaschinski, A. Bluethgen, F. Vogel, A. Tscheu, T. Fuchs, M. Wattenberg, T. Helmes, S. Scieszka, M. Heintz, S. Sakka, J. Kohler, F. Fiedler, M. Danz, Y. Sakr, R. Riessen, T. Kerz, A. Kersten, F. Tacke, G. Marx, T. Volkert, A. Schmutz, A. Nierhaus, S. Kluge, P. Abel, R. Janosi, S. Utzolino, H. Bracht, S. Toussaint, M. Giannakou Peftoulidou, P. Myrianthefs, A. Armaganidis, C. Routsi, A. Xini, E. Mouloudi, I. Kokoris, G. Kyriazopoulos, S. Vlachos, A. Lavrentieva, P. Partala, G. Nakos, A. Moller, S. Stefansson, J. Barry, R. O'Leary, C. Motherway, M. Faheem, E. Dunne, M. Donnelly, T. Konrad, E. Bonora, C. Achilli, S. Rossi, G. Castiglione, A. Peris, D. Albanese, N. Stocchetti, G. Citerio, L. Mozzoni, E. Sisillo, P. De Negri, M. Savioli, P. Vecchiarelli, F. Puflea, V. Stankovic, G. Minoja, S. Montibeller, P. Calligaro, R. Sorrentino, M. Feri, M. Zambon, E. Colombaroli, A. Giarratano, T. Pellis, C. Capra, M. Antonelli, A. Gullo, C. Chelazzi, A. De Capraris, N. Patroniti, M. Girardis, F. Franchi, G. Berlot, M. Buttigieg, H. Ponssen, J. Ten Cate, L. Bormans, S. Husada, M. Buise, B. Van Der Hoven, A. Reidinga, M. Kuiper, P. Pickkers, G. Kluge, S. Den Boer, J. Kesecioglu, H. Van Leeuwen, H. Flaatten, S. Mo, V. Branco, F. Rua, E. Lafuente, M. Sousa, N. Catorze, M. Barros, L. Pereira, A. Vintém De Oliveira, J. Gomes, I. Gaspar, M. Pereira, M. Cymbron, A. Dias, E. Almeida, S. Beirao, I. Serra, R. Ribeiro, P. Povoa, F. Faria, Z. Costa-E-Silva, J. Nóbrega, F. Fernandes, J. Gabriel, G. Voga, E. Rupnik, L. Kosec, M. Kerin Povšic, I. Osojnik, V. Tomic, A. Sinkovic, J. González, E. Zavala, J. Pérez Valenzuela, L. Marina, P. Vidal-Cortés, P. Posada, A. Ignacio Martin-Loeches, N. Muñoz Guillén, M. Palomar, J. Sole-Violan, A. Torres, M. Gonzalez Gallego, G. Aguilar, R. Montoiro Allué, M. Argüeso, M. Parejo, M. Palomo Navarro, A. Jose, N. Nin, F. Alvarez Lerma, O. Martinez, E. Tenza Lozano, S. Arenal López, M. Perez Granda, S. Moreno, C. Llubia, C. De La Fuente Martos, P. Gonzalez-Arenas, N. Llamas Fernández, B. Gil Rueda, I. Estruch Pons, N. Cruza, F. Maroto, A. Estella, A. Ferrer, L. Iglesias Fraile, Q, Brigida, A. Quintano, M. Tebar, F. Frutos-Vivar, A. Reyes, A. Rodríguez, A. Abella, S. García Del Valle, S. Yus, E. Maseda, J. Berezo, A. Tejero Pedregosa, C. Laplaza, R. Ferrer, J. Rico-Feijoo, M. Rodríguez, P. Monedero, K. Eriksson, D. Lind, D. Chabanel, H. Zender, K. Heer, B. Frankenberger, S. Jakob, A. Haller, S. Mathew, R. Downes, C. Barrera Groba, A. Johnston, R. Meacher, R. Keays, P. Haji-Michael, C. Tyler, A. Ferguson, S. Jones, D. Tyl, A. Ball, J. Vogel, M. Booth, P. Downie, M. Watters, S. Brett, M. Garfield, L. Everett, S. Heenen, S. Dhir, Z. Beardow, M. Mostert, S. Brosnan, N. Pinto, S. Harris, A. Summors, N. Andrew, A. Rose, R. Appelboam, O. Davies, E. Vickers, B. Agarwal, T. Szakmany, S. Wimbush, K. Williams, R. Pearse, R. Hollands, J. Kirk-Bayley, N. Fletcher, B. Bray, D. Brealey. The online version of the article has been corrected
A worldwide perspective of sepsis epidemiology and survival according to age: Observational data from the ICON audit
No full textMethods: We performed a secondary analysis of data from the prospective ICON audit, in which all adult ( >16 years ) patients admitted to participating ICUs between May 8 and 18, 2012, were included, except admissions for routine postoperative observation. For this sub-analysis, the 10,012 patients with completed age data were included. They were divided into five age groups - = 50, 51-60, 61-70, 71-80, >80 years. Sepsis was defined as infection plus at least one organ failure.[Marjanek, Z.] Javorszky Odon Hosp, Vac, Hungary.[Kokarev, E.] Railway Hosp Khabarovsk, Khabarovsk, Russia.[Ma, S.] Tongji Univ, Shanghai East Hosp, Shanghai, Peoples R China.[Kang, Y.] West China Hosp, Scu, Peoples R China.[Yu, L.] Wuhan Ctr Hosp, Wuhan, Hubei, Peoples R China.[Peng, Q.] Xiangya Hosp, Changsha, Hunan, Peoples R China.[Sun, R.] Zhejiang Prov Peoples Hosp, Hangzhou, Zhejiang, Peoples R China.[Yeung, A.] Pamela Youde Nethersole Eastern Hosp, Hong Kong, Peoples R China.[Wan, W.] Princess Margaret Hosp, Hong Kong, Peoples R China.[Sin, K.] Queen Elizabeth Hosp, Hong Kong, Peoples R China.[Lee, K.] United Christian Hosp Hong Kong SAR, Hong Kong, Peoples R China.[Wei, Y.] Yantai Yuhuangding Hosp, Yantai, Peoples R China.[Zhang, W.] Yantaishan Hosp, Yantai, Shandong, Peoples R China.[Wijanti, M.] Anestesi, Yogyakarta, Indonesia.[Widodo, U.] Pku Muhammadiyah Bantu, Yogyakarta, Indonesia.[Samsirun, H.] Rd Mattaher Hosp Jambi, Jambi City, Indonesia.[Cosar, A.] Gulhane Mil Med Acad, Ankara, Turkey.[Villagomez, A.] Hosp 1 Octubre, Issste, Mexico.[Samaddar, D.] Tata Main Hosp, Jamshedpur, Jharkhand, India.[Gusu, D.] Notre Dame, Brussels, Belgium.[Kalaitzis, E.] CHR Dax, Dax, France.Purpose: To investigate age-related differences in outcomes of critically ill patients with sepsis around the world.Results: A total of 2963 patients had sepsis, with similar proportions across the age groups (= 50 = 25.2%: 51-60 = 30.3%; 61-70 = 32.8%; 71-80 = 30.7%; >80 = 30.9%). Hospital mortality increased with age and in patients >80 years was almost twice that of patients = 50 years (493% vs 25.2%, p .05). The maximum rate of increase in mortality was about 0.75% per year, occurring between the ages of 71 and 77 years. In multilevel analysis, age > 70 years was independently associated with increased risk of dying.[Sakr, Y.] Uniklinikum Jena, Jena, Germany.Conclusions: The odds for death in ICU patients with sepsis increased with age with the maximal rate of increase occurring between the ages of 71 and 77 years. (C) 2019 Elsevier Inc. 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Valcoreanu] Spitalul Cf 2 Bucuresti, Bucharest, Romania.[Slavcovici, A.] Iuliu Hatieganu Univ Med ; Pharm, Teaching Hosp Infect Dis, Cluj Napoca, Romania.[Bagin, V] City Clin Hosp 40, St Petersburg, Russia.[Belsky, D.] City Hosp 40, St Petersburg, Russia.[Palyutin, S.] Clin Hosp NVNV Solovyev, Yaroslavl, Russia.[Shlyapnikov, S.] Emergency Res Inst NA Djanelidze, St Petersburg, Russia.[Bikkulova, D.] Fed Res Ctr Paediat Haematol Oncol ; Immunol, Moscow, Russia.[Gritsan, A.] Krasnoyarsk State Med Univ, Krasnoyarsk Reg Hosp, Krasnoyarsk, Russia.[Natalia, G.] Med Assoc Novaya Bolnitsa, Ekaterinburg, Russia.[Makarenko, E.] Mil Med Acad, Ekaterinburg, Russia.[Kokhno, V] Novosibirsk Med Univ, Novosibirsk, Russia.[Tolkach, A.] Omsk Reg Clin Hosp, Omsk, Russia.[Belotserkovskiy, B.] St Alexy Hosp, St Louis, France.[Zolotukhin, K.] State Dist Hosp, Moscow, Russia.[Kulabukhov, V] Vishnevsky Inst Surg, Moscow, Russia.[Soskic, L.] Clin Ctr Serbia, Clin Cardiac Surg, Belgrade, Serbia.[Palibrk, I] Clin Ctr Serbia, Clin Digest Surg, Belgrade, Serbia.[Jankovic, R.; 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Xiaobo, H.] Sichuan Prov Peoples Hosp, Chengdu, Sichuan, Peoples R China.[Ge, H.] Sir Run Run Shaw Hosp, Hangzhou, Zhejiang, Peoples R China.[Yan, T.] Affiliated Guiyang Med Coll, Guiyang, Guizhou, Peoples R China.[Yuhui, C.] Fudan Univ, Peoples Hosp Shanghai 5, Shanghai, Peoples R China.[Zhang, J.] Dalian Med Univ, Affiliated Hosp 1, Dalian, Peoples R China.[Jian-Hong, F.] Suzhou Univ, Affiliated Hosp 1, Suzhou, Peoples R China.[Zhu, H.] Xinjiang Med Univ, Affiliated Hosp 1, Urumqi, Peoples R China.[Huo, F.; Wang, Y.] Jilin Univ, Hosp 1, Changchun, Jilin, Peoples R China.[Li, C.] First Peoples Hosp Kunming, Kunming, Yunnan, Peoples R China.[Zhuang, M.] Gen Hosp Shenyang Mil Reg, Shenyang, Liaoning, Peoples R China.[Ma, Z.] Peoples Hosp Cangzhou, Cangzhou, Peoples R China.[Sun, J.] Jilin Univ, Hosp 2, Changchun, Jilin, Peoples R China.[Liuqingyue, L.] Second Peoples Hosp Liaocheng City Shandong Prov, Liaocheng, Shandong, Peoples R China.[Yang, M.] Third Xiangya Hosp, Changsha, Hunan, Peoples R China.[Meng, J.] Tongde Hosp Zhejiang Prov, Hangzhou, Zhejiang, Peoples R China.[Sugiman, T.] Rumah Sakit Pantai Lndah Kapuk, North Jakarta, Indonesia.[Wisudarti, C.] Sardjito Hosp, Yogyakarta, Indonesia.[Maskoen, T.] Sch Med Unpad, Hasan Sadikin Hosp, Bandung, Indonesia.[Hata, N.] Nippon Med Sch, Chiba Hokusoh Hosp, Inzai, Japan.[Kobe, Y.] Chiba Univ Hosp, Chiba, Japan.[Nishida, O.] Fujita Hlth Univ, Sch Med, Toyoake, Aichi, Japan.[Miyazaki, D.] Japanese Red Cross Maebashi Hosp, Maebashi, Gumma, Japan.[Nunomiya, S.] Jichi Med Univ Hosp, Shimotsuke, Japan.[Uchino, S.] Jikei Univ, Sch Med, Tokyo, Japan.[Kitamura, N.] Kimitsu Chuo Hosp, Kisarazu, Japan.[Yamashita, K.] Kochi Med Sch, Nankoku, Kochi, Japan.[Hashimoto, S.] Kyoto Prefectural Univ Med, Kyoto, Japan.[Fukushima, H.] Nara Med Univ Hosp, Kashihara, Nara, Japan.[Adib, N. Nik] Hosp Sultanah Nur Zahirah, Kuala Terengganu, Terengganu, Malaysia.[Tai, L.] Kuala Lumpur Hosp, Kuala Lumpur, Malaysia.[Tony, B.] Queen Elizabeth Hosp 2, Kota Kinabalu, Malaysia.[Bigornia, R.] Cebu Velez Gen Hosp, Cebu, Philippines.[Bigornia, R.] Perpetual Succour Hosp, Cebu, Philippines.[Palo, J.] Med City, Pasig, Philippines.[Chatterjee, S.] Alexandra Hosp, Singapore, Singapore.[Tan, B.] Natl Univ Hlth Syst, Singapore, Singapore.[Kong, A.] Singapore Gen Hosp, Singapore, Singapore.[Goh, S.] Tan Tock Seng Hosp, Singapore, Singapore.[Lee, C.] Natl Taiwan Univ Hosp, Taipei, Taiwan.[Pothirat, C.] Chiaingmai Univ, Maharaj Nakorn Chiangmai Hosp, Chiang Mai, Thailand.[Khwannimit, B.] Prince Songkla Univ, Hat Yai, Thailand.[Theerawit, P.] Ramathibodi Hosp, Bangkok, Thailand.[Pornsuriyasak, P.] Ramathibodi Hosp, Somdech Phra Debaratana Med Ctr, Bangkok, Thailand.[Piriyapatsom, A.] Mahidol Univ, Siriraj Hosp, Bangkok, Thailand.[Mukhtar, A.] Cairo Univ, Giza, Egypt.[Dsicu] Demerdash Surg Intens Care Unit, Cairo, Egypt.[Hamdy, A. Nabil] Ain Shams Fac Med, Cairo, Egypt.[Hosny, H.] Zaitoun Specialized Hosp, Cairo, Egypt.[Ashraf, A.] Gums, Tehran, Iran.[Mokhtari, M.] Sbums, Imam Hossein Hosp, Tehran, Iran.[Nowruzinia, S.] Imamreza Hosp, Mashhad, Razavi Khorasan, Iran.[Lotfi, A.] Laleh Hosp, Tehran, Iran.[Zand, F.] Shiraz Anesthesiol ; Crit Care Res Ctr, Shiraz, Iran.[Nikandish, R.] Shiraz Univ Med Sci, Shiraz, Iran.[Moghaddam, O. Moradi] Tehran Med Sci Univ, Tehran, Iran.[Cohen, J.] Rabin Med Ctr, Petah Tiqwa, Israel.[Sold, O.] Sourasky Tel Aviv Med Ctr, Tel Aviv, Israel.[Sfeir, T.] Ctr Hosp Nord, Ettelbruck, Luxembourg.[Hasan, A.] Sohar Hosp, Sohar, Oman.[Abugaber, D.] Specialized Arab Hosp, Nablus, Palestine.[Ahmad, H.] Almana Gen Hosp, Khobar, Saudi Arabia.[Tantawy, T.] KFSHRC, Riyadh, Saudi Arabia.[Baharoom, S.] King Abdulaziz Med City Riyadh, Riyadh, Saudi Arabia.[Algethamy, H.] King Abdulaziz Univ, Jeddah, Saudi Arabia.[Amr, A.] King Saud Med City, Riyadh, Saudi Arabia.[Almekhlafi, G.] Riyadh Mil Hosp, Riyadh, Saudi Arabia.[Coskun, R.] Erciyes Univ, Med Fac, Kayseri, Turkey.[Sungur, M.] Erciyes Univ, Med Sch, Kayseri, Turkey.[Gucyetmez, B.] Int Hosp, Istanbul, Turkey.[Demirkiran, O.] Istanbul Univ, Cerrahpasa Med Sch Hosp, Istanbul, Turkey.[Senturk, E.] Istanbul Univ, Istanbul Med Fac, Istanbul, Turkey.[Ulusoy, H.] Karadeniz Tech Univ, Med Fac, Trabzon, Turkey.[Atalan, H.] Mem Atasehir Hosp, Istanbul, Turkey.[Serin, S.] Pamukkale Univ, Denizli, Turkey.[Kati, I] Yuzuncu Yil Univ, Med Fac, Van, Turkey.[Alnassrawi, Z.] Dubai Hosp, Dubai, U Arab Emirates.[Almemari, A.] Mafraq Hosp, Abu Dhabi, U Arab Emirates.[Krishnareddy, K.] Sheikh Khalifa Med City, Abu Dhabi, U Arab Emirates.[Kashef, S.] Tawam Hosp, Al Ain, U Arab Emirates.[Alsabbah, A.] City Hosp, Dubai, U Arab Emirates.[Poirier, G.] Hop Charles Lemoyne, Longueuil, PQ, Canada.[Marshall, J.] St Michaels Hosp, Toronto, ON, Canada.[Herridge, M.] Toronto Gen Hosp, Toronto, ON, Canada.[Herridge, M.] Toronto Western Hosp, Toronto, ON, Canada.[Fernandez-Medero, R.] San Juan Hosp, San Juan, PR USA.[Fulda, G.] Christiana Care Hlth Syst, Newark, DE USA.[Banschbach, S.] Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 USA.[Quintero, J.] El Camino Hosp, Mountain View, CA USA.[Schroeder, E.] George Washington Hosp, Washington, DC USA.[Sicoutris, C.] Hosp Univ Penn, Philadelphia, PA 19104 USA.[Gueret, R.] John H Stroger Hosp Cook Cty, Chicago, IL USA.[Ryan, A.] Washington Hosp Ctr, 2H, Washington, DC USA.[Ryan, A.] Washington Hosp Ctr, 2G, Washington, DC USA.[Ryan, A.] Washington Hosp Ctr, 3H, Washington, DC USA.[Ryan, A.] Washington Hosp Ctr, 3G, Washington, DC USA.[Kashyap, R.] Mayo Clin, CCM, Rochester, MN USA.[Bauer, P.] Mayo Clin, PCC, Rochester, MN USA.[Freebairn, R.] Hawkes Bay Hosp, Hastings, New Zealand.[Nistor, D.] Palmerston North Hosp, Midcent Hlth, Palmerston North, New Zealand.[Oxley, C.] Middlemore Hosp, Auckland, New Zealand.[Young, P.] Wellington Hosp, Wellington, New Zealand.[Nanchal, R.] Med Coll Wisconsin, Milwaukee, WI 53226 USA.[Wunderink, R.] Northwestern Mem Hosp, Chicago, IL 60611 USA.[Jimenez, E.] Orlando Reg Med Ctr Inc, Orlando, FL USA.[Ryan, A.] Washington Hosp Ctr, Washington, DC 20010 USA.[Ryan, A.] Washington Hosp Ctr, 4H, Washington, DC USA.[Ryan, A.] Washington Hosp Ctr, CVRR, Washington, DC USA.[Prince, D.] Armadale Hlth Serv, Mount Nasura, WA, Australia.[Edington, J.] Bendigo Hosp, Bendigo, Vic, Australia.[Van Haren, F.] Canberra Hosp, Canberra, ACT, Australia.[Bersten, A.] Flinders Med Ctr, Bedford Pk, SA, Australia.[Hawkins, D. J.] Joondalup Hlth Campus, Joondalup, WA, Australia.[Kilminster, M.] Lismore Base Hosp, Lismore, NSW, Australia.[Sturgess, D.] Mater Adult Hosp, South Brisbane, Qld, Australia.[Ziegenfuss, M.] Prince Charles Hosp, Brisbane, Qld, Australia.[O'Connor, S.] Royal Adelaide Hosp, Adelaide, SA, Australia.[Lipman, J.] Royal Brisbane ; Womens Hosp, Brisbane, Qld, Australia.[Campbell, L.] Royal Darwin Hosp, Tiwi, NT, Australia.[Mcallister, R.] Royal Hobart Hosp, Hobart, Tas, Australia.[Roberts, B.] Sir Charles Gairdner Hosp, Nedlands, WA, Australia.[Williams, P.] Queen Elizabeth Hosp, Woodville, SA, Australia.[Parke, R.] Auckland Dist Hlth Board, Auckland, New Zealand.[Seigne, P.] Christchurch Hosp, Christchurch, New Zealand.[Valentini, R.] Cemic, Buenos Aires, DF, Argentina.[Wainsztein, N.] Fleni, Buenos Aires, DF, Argentina.[Comignani, P.] Hosp Aleman, Buenos Aires, DF, Argentina.[Casaretto, M.] Hosp Cent San Isidro, Buenos Aires, DF, Argentina.[Sutton, G.] Hosp Fernandez, Buenos Aires, DF, Argentina.[Villegas, P.] Hosp Francisco Lopez Lima Area Programa Gen Roca, Gen Roca, Argentina.[Galletti, C.] Sanatorio Allende, Cordoba, Argentina.[Neira, J.] Sanatorio Trinidad Palermo, Buenos Aires, DF, Argentina.[Rovira, D.] Sanatorio Julio Corzo Rosario, Rosario, Santa Fe, Argentina.[Hidalgo, J.] Karl Heusner Mem Hosp, Belize City, Belize.[Hidalgo, J.] Belize Healthcare Partner, Belize City, Belize.[Sandi, F.] Hosp Obrero 1, La Paz, Bolivia.[Caser, E.] Cias Unimed Vitoria, Vitoria, ES, Brazil.[Thompson, M.] Evangelical Hosp Cachoeiro De Itapemirim, Cachoeiro De Itapemirim, Brazil.[D'agostino Dias, M.] Hosp 9 Julho, Sao Paulo, Brazil.[Fontes, L.] Hosp Alcides Carneiro, Petropolis, Brazil.[Lunardi, M.] Hosp Clin Luzia De Pinho Melo, Mogi Das Cruzes, Brazil.[Youssef, N.] Hosp Nacoes Curitiba, Curitiba, Parana, Brazil.[Lobo, S.] Hosp Base Famerp, Sao Jose Do Rio Preto, Brazil.[Silva, R.] Hosp Clin Niteroi, Niteroi, RJ, Brazil.[Sales Jr, J.] Hosp Clin Padre Miguel, Rio De Janeiro, Brazil.[Madeira Campos Melo, L.] Hosp Terapia Intens, Sao Paulo, Brazil.[Oliveira, M.] Hosp Trabalhador, Curitiba, Parana, Brazil.[Fonte, M.] Hosp Esperanza, Olinda, PE, Brazil.[Grion, C.] Hosp Evangel Londrina, Londrina, Brazil.[Feijo, C.] Hosp Geral Fortaleza, Fortaleza, Ceara, Brazil.[Rezende, V] Hosp Geral Roraima, Boa Vista, Brazil.[Assuncao, M.] Hosp Israelita Albert Einstein, Sao Paulo, Brazil.[Neves, A.] Hosp Mater Dei, Belo Horizonte, MG, Brazil.[Gusman, P.; Dalcomune, D.] Hosp Meridional, Cariacica, ES, Brazil.[Teixeira, C.] Hosp Moinhos Vento, Porto Alegre, RS, Brazil.[Kaefer, K.] Hosp Municipal Ruth Cardoso, Balneario, Brazil.[Maia, I] Hosp Nereu Ramos, Florianopolis, SC, Brazil.[Souza Dantas, V] Hosp Pasteur, Rio De Janeiro, Brazil.[Costa Filho, R.] Hosp Pro Cardiaco, Rio De Janeiro, Brazil.[Amorim, F.] Hosp Reg Samambaia, Brasilia, DF, Brazil.[Assef, M.] Hosp Reg Hans Dieter Schmidt, Joinville, Brazil.[Schiavetto, P.] Hosp Santa Casa Campo Mourao, Campo Mourao, PR, Brazil.[Houly, J.] Hosp Santa Paula, Sao Paulo, SP, Brazil.[Houly, J.] Hosp Santapaula, Sao Paulo, Brazil.[Bianchi, F.] Hosp Sao Jose Avai, Itaperuna, RJ, Brazil.[Dias, F.] Hosp Sao Lucas Pucrs, Porto Alegre, RS, Brazil.[Avila, C.] Hosp Sao Vicente Paula, Rio De Janeiro, RJ, Brazil.[Gomez, J.] Hosp Sao Vicente Paulo, Rio De Janeiro, Brazil.[Rego, L.] Hosp Saude Mulher, Belem, Para, Brazil.[Castro, P.] Hosp Tacchini, Bento Goncalves, RS, Brazil.[Passos, J.] Hosp Unimed Costa Do Sol Macae Rj, Macae, RJ, Brazil.[Mendes, C.] Hosp Univ Ufpb Joao Pessoa, Joao Pessoa, Paraiba, Brazil.[Grion, C.] Hosp Univ Londrina, Londrina, Brazil.[Colozza Mecatti, G.] Hosp Univ Sao Francisco, Braganca Paulista, SP, Brazil.[Ferrreira, M.] Santa Casa Caridade Diamantina, Diamantina, MG, Brazil.[Irineu, V] Santa Casa Misericordia Tatui, Tatui, Brazil.[Guerreiro, M.] Sao Francisco de Paula Hosp, Sao Francisco De Paula, RS, Brazil.[Ugarte, S.] Clin Indisa, Providencia, Chile.[Tomicic, V] Clin Las Lilas, Providencia, Chile.[Godoy, C.] Hosp Carlos Van Buren, Valparaiso, Chile.[Samaniego, W.] Hosp Trabajador Santiago, Santiago, Chile.[Escamilla, I] Hosp El Pino, San Bernardo, Chile.[Escamilla, I] Hosp Mutual De Seguridad, Santiago, Chile.[Castro Castro, L.] Ctr Med Imbanaco, Valle Del Cauca, Colombia.[Libreros Duque, G.] Clin Colombia Cali, Cali, Colombia.[Diaz-Guio, D.] Clin De
Higher Fluid Balance Increases the Risk of Death from Sepsis: Results from a Large International Audit∗
No full textObjectives: Excessive fluid therapy in patients with sepsis may be associated with risks that outweigh any benefit. We investigated the possible influence of early fluid balance on outcome in a large international database of ICU patients with sepsis. Design: Observational cohort study. Setting: Seven hundred and thirty ICUs in 84 countries. Patients: All adult patients admitted between May 8 and May 18, 2012, except admissions for routine postoperative surveillance. For this analysis, we included only the 1,808 patients with an admission diagnosis of sepsis. Patients were stratified according to quartiles of cumulative fluid balance 24 hours and 3 days after ICU admission. Measurements and Main Results: ICU and hospital mortality rates were 27.6% and 37.3%, respectively. The cumulative fluid balance increased from 1,217 mL (-90 to 2,783 mL) in the first 24 hours after ICU admission to 1,794 mL (-951 to 5,108 mL) on day 3 and decreased thereafter. The cumulative fluid intake was similar in survivors and nonsurvivors, but fluid balance was less positive in survivors because of higher fluid output in these patients. Fluid balances became negative after the third ICU day in survivors but remained positive in nonsurvivors. After adjustment for possible confounders in multivariable analysis, the 24-hour cumulative fluid balance was not associated with an increased hazard of 28-day in-hospital death. However, there was a stepwise increase in the hazard of death with higher quartiles of 3-day cumulative fluid balance in the whole population and after stratification according to the presence of septic shock. Conclusions: In this large cohort of patients with sepsis, higher cumulative fluid balance at day 3 but not in the first 24 hours after ICU admission was independently associated with an increase in the hazard of death
Effect of lung recruitment and titrated Positive End-Expiratory Pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome - A randomized clinical trial
No full textIMPORTANCE: The effects of recruitment maneuvers and positive end-expiratory pressure (PEEP) titration on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remain uncertain. OBJECTIVE: To determine if lung recruitment associated with PEEP titration according to the best respiratory-system compliance decreases 28-day mortality of patients with moderate to severe ARDS compared with a conventional low-PEEP strategy. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, randomized trial conducted at 120 intensive care units (ICUs) from 9 countries from November 17, 2011, through April 25, 2017, enrolling adults with moderate to severe ARDS. INTERVENTIONS: An experimental strategy with a lung recruitment maneuver and PEEP titration according to the best respiratory-system compliance (n = 501; experimental group) or a control strategy of low PEEP (n = 509). All patients received volume-assist control mode until weaning. MAIN OUTCOMES AND MEASURES: The primary outcome was all-cause mortality until 28 days. Secondary outcomes were length of ICU and hospital stay; ventilator-free days through day 28; pneumothorax requiring drainage within 7 days; barotrauma within 7 days; and ICU, in-hospital, and 6-month mortality. RESULTS: A total of 1010 patients (37.5% female; mean [SD] age, 50.9 [17.4] years) were enrolled and followed up. At 28 days, 277 of 501 patients (55.3%) in the experimental group and 251 of 509 patients (49.3%) in the control group had died (hazard ratio [HR], 1.20; 95% CI, 1.01 to 1.42; P = .041). Compared with the control group, the experimental group strategy increased 6-month mortality (65.3% vs 59.9%; HR, 1.18; 95% CI, 1.01 to 1.38; P = .04), decreased the number of mean ventilator-free days (5.3 vs 6.4; difference, −1.1; 95% CI, −2.1 to −0.1; P = .03), increased the risk of pneumothorax requiring drainage (3.2% vs 1.2%; difference, 2.0%; 95% CI, 0.0% to 4.0%; P = .03), and the risk of barotrauma (5.6% vs 1.6%; difference, 4.0%; 95% CI, 1.5% to 6.5%; P = .001). There were no significant differences in the length of ICU stay, length of hospital stay, ICU mortality, and in-hospital mortality. CONCLUSIONS AND RELEVANCE: In patients with moderate to severe ARDS, a strategy with lung recruitment and titrated PEEP compared with low PEEP increased 28-day all-cause mortality. These findings do not support the routine use of lung recruitment maneuver and PEEP titration in these patients. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01374022
Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies
No full textBackground: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies.
Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality.
Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001).
Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status
A worldwide perspective of sepsis epidemiology and survival according to age: Observational data from the ICON audit
No full textPurpose: To investigate age-related differences in outcomes of critically ill patients with sepsis around the world. Methods: We performed a secondary analysis of data from the prospective ICON audit, in which all adult ( >16 years ) patients admitted to participating ICUs between May 8 and 18, 2012, were included, except admissions for routine postoperative observation. For this sub-analysis, the 10,012 patients with completed age data were included. They were divided into five age groups - <= 50, 51-60, 61-70, 71-80, >80 years. Sepsis was defined as infection plus at least one organ failure. Results: A total of 2963 patients had sepsis, with similar proportions across the age groups (<= 50 = 25.2%: 51-60 = 30.3%; 61-70 = 32.8%; 71-80 = 30.7%; >80 = 30.9%). Hospital mortality increased with age and in patients >80 years was almost twice that of patients <= 50 years (493% vs 25.2%, p < .05). The maximum rate of increase in mortality was about 0.75% per year, occurring between the ages of 71 and 77 years. In multilevel analysis, age > 70 years was independently associated with increased risk of dying. Conclusions: The odds for death in ICU patients with sepsis increased with age with the maximal rate of increase occurring between the ages of 71 and 77 years. (C) 2019 Elsevier Inc. All rights reserved
Being Overweight Is Associated With Greater Survival in ICU Patients: Results From the Intensive Care Over Nations Audit
No full textCorrection to collaborators in acknowledgments in: Decision-making on withholding or withdrawing life support in the ICU: A worldwide perspective
No full textThe authors have reported to CHEST that the collaborators from the ICON Investigators were omitted from the Acknowledgments in “Decision-Making on Withholding or Withdrawing Life Support in the ICU: A Worldwide Perspective” (Chest. 2017;152(2):321-329). https://doi.org/10.1016/j.chest.2017.04.17
