Acute respiratory distress syndrome in mechanically ventilated patients with community-acquired pneumonia

Our aim was to assess the incidence, characteristics, aetiology, risk factors and mortality of acute respiratory distress syndrome (ARDS) in intensive care unit (ICU) patients with community-acquired pneumonia (CAP) using the Berlin definition. We prospectively enrolled consecutive mechanically vent...

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Autores: Cillóniz, Catia, Ferrer Monreal, Miquel, Liapikou, Adamantia, Garcia Vidal, Carolina, Gabarrús, Albert, Ceccato, Adrian, Puig de la Bellacasa, Jordi, Blasi, Francesco, Torres Martí, Antoni
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2018
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/136597
Acceso en línea:https://hdl.handle.net/2445/136597
Access Level:acceso abierto
Palabra clave:Pneumònia adquirida a la comunitat
Malalties de l'aparell respiratori
Community-acquired pneumonia
Respiratory diseases
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spelling Acute respiratory distress syndrome in mechanically ventilated patients with community-acquired pneumonia Cillóniz, Catia Ferrer Monreal, Miquel Liapikou, Adamantia Garcia Vidal, Carolina Gabarrús, Albert Ceccato, Adrian Puig de la Bellacasa, Jordi Blasi, Francesco Torres Martí, Antoni Pneumònia adquirida a la comunitat Malalties de l'aparell respiratori Community-acquired pneumonia Respiratory diseases Our aim was to assess the incidence, characteristics, aetiology, risk factors and mortality of acute respiratory distress syndrome (ARDS) in intensive care unit (ICU) patients with community-acquired pneumonia (CAP) using the Berlin definition. We prospectively enrolled consecutive mechanically ventilated adult ICU patients with CAP over 20 years, and compared them with mechanically ventilated patients without ARDS. The main outcome was 30-day mortality. Among 5334 patients hospitalised with CAP, 930 (17%) were admitted to the ICU and 432 required mechanical ventilation; 125 (29%) cases met the Berlin ARDS criteria. ARDS was present in 2% of hospitalised patients and 13% of ICU patients. Based on the baseline arterial oxygen tension/inspiratory oxygen fraction ratio, 60 (48%), 49 (40%) and 15 (12%) patients had mild, moderate and severe ARDS, respectively. Streptococcus pneumoniae was the most frequent pathogen, with no significant differences in aetiology between groups. Higher organ system dysfunction and previous antibiotic use were independent risk factors for ARDS in the multivariate analysis, while previous inhaled corticosteroids were independently associated with a lower risk. The 30-day mortality was similar between patients with and without ARDS (25% versus 30%, p=0.25), confirmed by propensity-adjusted multivariate analysis. ARDS occurs as a complication of CAP in 29% of mechanically ventilated patients, but is not related to the aetiology or mortality. European Respiratory Society https://hdl.handle.net/2445/136597
title Acute respiratory distress syndrome in mechanically ventilated patients with community-acquired pneumonia
spellingShingle Acute respiratory distress syndrome in mechanically ventilated patients with community-acquired pneumonia
Cillóniz, Catia
Pneumònia adquirida a la comunitat
Malalties de l'aparell respiratori
Community-acquired pneumonia
Respiratory diseases
title_short Acute respiratory distress syndrome in mechanically ventilated patients with community-acquired pneumonia
title_full Acute respiratory distress syndrome in mechanically ventilated patients with community-acquired pneumonia
title_fullStr Acute respiratory distress syndrome in mechanically ventilated patients with community-acquired pneumonia
title_full_unstemmed Acute respiratory distress syndrome in mechanically ventilated patients with community-acquired pneumonia
title_sort Acute respiratory distress syndrome in mechanically ventilated patients with community-acquired pneumonia
author Cillóniz, Catia
author_facet Cillóniz, Catia
Ferrer Monreal, Miquel
Liapikou, Adamantia
Garcia Vidal, Carolina
Gabarrús, Albert
Ceccato, Adrian
Puig de la Bellacasa, Jordi
Blasi, Francesco
Torres Martí, Antoni
author_role author
author2 Ferrer Monreal, Miquel
Liapikou, Adamantia
Garcia Vidal, Carolina
Gabarrús, Albert
Ceccato, Adrian
Puig de la Bellacasa, Jordi
Blasi, Francesco
Torres Martí, Antoni
author2_role author
author
author
author
author
author
author
author
topic Pneumònia adquirida a la comunitat
Malalties de l'aparell respiratori
Community-acquired pneumonia
Respiratory diseases
topic_facet Pneumònia adquirida a la comunitat
Malalties de l'aparell respiratori
Community-acquired pneumonia
Respiratory diseases
description Our aim was to assess the incidence, characteristics, aetiology, risk factors and mortality of acute respiratory distress syndrome (ARDS) in intensive care unit (ICU) patients with community-acquired pneumonia (CAP) using the Berlin definition. We prospectively enrolled consecutive mechanically ventilated adult ICU patients with CAP over 20 years, and compared them with mechanically ventilated patients without ARDS. The main outcome was 30-day mortality. Among 5334 patients hospitalised with CAP, 930 (17%) were admitted to the ICU and 432 required mechanical ventilation; 125 (29%) cases met the Berlin ARDS criteria. ARDS was present in 2% of hospitalised patients and 13% of ICU patients. Based on the baseline arterial oxygen tension/inspiratory oxygen fraction ratio, 60 (48%), 49 (40%) and 15 (12%) patients had mild, moderate and severe ARDS, respectively. Streptococcus pneumoniae was the most frequent pathogen, with no significant differences in aetiology between groups. Higher organ system dysfunction and previous antibiotic use were independent risk factors for ARDS in the multivariate analysis, while previous inhaled corticosteroids were independently associated with a lower risk. The 30-day mortality was similar between patients with and without ARDS (25% versus 30%, p=0.25), confirmed by propensity-adjusted multivariate analysis. ARDS occurs as a complication of CAP in 29% of mechanically ventilated patients, but is not related to the aetiology or mortality.
publishDate 2018
format article
status_str acceptedVersion
url https://hdl.handle.net/2445/136597
eu_rights_str_mv openAccess
publisher European Respiratory Society
institution Universidad de Barcelona
collection Dipòsit Digital de la UB
reponame_str Dipòsit Digital de la UB
instname_str Universidad de Barcelona
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publishDateSort 2018
author_browse Blasi, Francesco
Ceccato, Adrian
Cillóniz, Catia
Ferrer Monreal, Miquel
Gabarrús, Albert
Garcia Vidal, Carolina
Liapikou, Adamantia
Puig de la Bellacasa, Jordi
Torres Martí, Antoni
publisherStr European Respiratory Society
score 6.924472

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