Predicting Survival After Extracorporeal Membrane Oxygenation for ARDS: An External Validation of RESP and PRESERVE Scores
| العنوان: | Predicting Survival After Extracorporeal Membrane Oxygenation for ARDS: An External Validation of RESP and PRESERVE Scores |
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| المؤلفون: | Gerard Babatasi, Pierre Verrier, Jennifer Brunet, Jean-Jacques Parienti, Xavier Valette, Bertrand Sauneuf, Yves Dalibert, Calin Ivascau, Philippe Lehoux, Dimitrios Buklas, Cédric Daubin, Damien du Cheyron, Nicolas Terzi, Amélie Seguin |
| المصدر: | Respiratory Care. 62:912-919 |
| بيانات النشر: | Daedalus Enterprises, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Adult, Male, Pulmonary and Respiratory Medicine, ARDS, medicine.medical_specialty, Maximal Respiratory Pressures, medicine.medical_treatment, Peak inspiratory pressure, Critical Care and Intensive Care Medicine, Severity of Illness Index, 03 medical and health sciences, Plateau pressure, Extracorporeal Membrane Oxygenation, 0302 clinical medicine, Predictive Value of Tests, Interquartile range, medicine, Extracorporeal membrane oxygenation, Humans, Hospital Mortality, 030212 general & internal medicine, Prospective cohort study, Retrospective Studies, Respiratory Distress Syndrome, Univariate analysis, business.industry, Area under the curve, 030208 emergency & critical care medicine, General Medicine, Middle Aged, medicine.disease, Respiration, Artificial, Surgery, surgical procedures, operative, ROC Curve, Area Under Curve, Anesthesia, Female, France, business |
| الوصف: | BACKGROUND: We aimed to test the performance of PRESERVE and RESP scores to predict death in patients with severe ARDS receiving extracorporeal membrane oxygenation (ECMO) with different case mixes. METHODS: All consecutive patients treated with ECMO for refractory ARDS, regardless of cause, in the Caen University Hospital in northwestern France over the last decade were included in a retrospective cohort study. The receiver operating characteristic curves of each score were plotted, and the area under the curve was computed to assess their performance in predicting mortality (c-index). RESULTS: Forty-one subjects were included. Pre-ECMO ventilator settings were: mean VT, 6.1 ± 0.9 mL/kg; breathing frequency, 32 ± 4 breaths/min; PEEP, 11 ± 4 cm H2O; peak inspiratory pressure, 48 ± 9 cm H2O; plateau pressure, 30.4 ± 4.4 cm H2O. At ECMO initiation, blood gas results were: pH 7.22 ± 0.17, PaO2/FIO2 = 63 ± 22 mm Hg; PaCO2 = 56 ± 18 mm Hg; FIO2 = 99 ± 2%. Pre-ECMO data were available in 35 and 27 subjects for calculation of the PRESERVE score and RESP score, respectively. Pre-ECMO scoring system results were: median PRESERVE score, 4 (interquartile range 2–5), and median RESP score, 0 (interquartile range −2 to 2). Twenty-three subjects (56%) died, including 19 receiving ECMO. In univariate analysis, plateau pressure (P = .031), driving pressure (P = CONCLUSIONS: The use of these scores in helping physicians to determine the patients with ARDS most likely to benefit from ECMO should be limited in clinical practice because of their relatively poor performance in predicting death in subjects with severe ARDS receiving ECMO support. Before widespread use is initiated, these scoring systems should be tested in large prospective studies of subjects with severe ARDS undergoing ECMO treatment. |
| تدمد: | 1943-3654 0020-1324 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bff9625690aed2bfc3d8ec7bba3284f4 https://doi.org/10.4187/respcare.05098 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....bff9625690aed2bfc3d8ec7bba3284f4 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19433654 00201324 |
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