Driving pressure and long-term outcomes in moderate/severe acute respiratory distress syndrome

中度/重度急性呼吸窘迫综合征的驱动压力和长期结果

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作者:Carlos Toufen Junior, Roberta R De Santis Santiago, Adriana S Hirota, Alysson Roncally S Carvalho, Susimeire Gomes, Marcelo Brito Passos Amato, Carlos Roberto Ribeiro Carvalho

Background

Acute respiratory distress syndrome (ARDS) patients may present impaired in lung function and structure after hospital discharge that may be related to mechanical ventilation strategy. The

Conclusion

Even in patients ventilated with protective tidal volume, higher driving pressure is associated with worse long-term pulmonary function and structure.

Results

Thirty-three patients were enrolled, and 21 patients survived after 6 months. In extubation day an association between driving pressure and NT-PCP-III was observed. At 1 and 6 months forced vital capacity (FVC) was negatively correlated to driving pressure (p < 0.01). At 6 months driving pressure was associated with lower FVC independently on tidal volume, plateau pressure and baseline static respiratory compliance after adjustments (r2 = 0.51, p = 0.02). There was a significant correlation between driving pressure and lung densities and nonaerated/poorly aerated lung volume after 6 months. Driving pressure was also related to general health domain of SF-36 at 6 months.

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