Resolution of Organ Functional Scores to Predict the Outcome in Adult Acute Respiratory Distress Syndrome Patients Receiving High-Frequency Oscillatory Ventilation

被引:3
作者
Kao, Kuo-Chin [1 ,2 ,3 ]
Yang, Cheng-Ta [1 ,2 ,3 ]
Hu, Han-Chung [1 ,2 ,3 ]
Ting, Hui-Ching [2 ]
Huang, Ching-Tzu [2 ]
Chou, Lan-Ti [2 ,4 ]
Hsiao, Hsiu-Feng [2 ,3 ]
Li, Li-Fu [1 ,2 ,3 ]
Tsai, Ying-Huang [1 ,2 ,3 ]
Huang, Chung-Chi [1 ,2 ,3 ]
机构
[1] Chang Gung Univ, Chang Gung Mem Hosp, Dept Thorac Med, Coll Med, Tao Yuan 333, Taiwan
[2] Chang Gung Univ, Chang Gung Mem Hosp, Dept Resp Therapy, Coll Med, Tao Yuan 333, Taiwan
[3] Chang Gung Univ, Dept Resp Care, Coll Med, Tao Yuan 333, Taiwan
[4] Chang Gung Inst Technol, Dept Resp Care, Chiayi, Taiwan
来源
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE | 2011年 / 71卷 / 06期
关键词
High-frequency oscillatory ventilation; Acute respiratory distress syndrome; Organ system failure; Sequential organ failure assessment; Multiple organ dysfunction score; ACUTE LUNG INJURY; MECHANICAL VENTILATION; FAILURE; TRIAL; MULTICENTER; DYSFUNCTION; MORTALITY; ARDS;
D O I
10.1097/TA.0b013e3182332102
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: High-frequency oscillatory ventilation (HFOV) may be used as a rescue therapy for adults with acute respiratory distress syndrome who have failed conventional ventilation (CV). We undertook a prospective study to investigate the determinants of mortality and the sequential evolution of organ failures in HFOV-treated adult acute respiratory distress syndrome patients. Methods: The indication for HFOV was severe oxygenation failure (PAO(2)/FiO(2) <120 mm Hg) while receiving aggressive CV support (defined by either PAO(2) <= 65 mm Hg with FiO(2) >= 0.6 when positive end-expiratory pressures >10 cmH(2)O or plateau airway pressure >= 35 cm H2O). Demographic, clinical, and physiologic data were collected prospectively (May 2007-July 2009). Organ System Failure (OSF), Sequential Organ Failure Assessment (SOFA), and Multiple Organ Dysfunction (MOD) scores were recorded during and after HFOV application. Additional outcome measures included HFOV successful weaning rate, cause of failure, complications, survival rate, and cause of death. Results: The intensive care unit mortality rate was 62% (21 of 34). Survivors had a significantly shorter CV time before HFOV than nonsurvivors (32.8 hours +/- 16.7 hours vs. 47.9 hours +/- 26.2 hours, p = 0.049). Survivors had significantly lower baseline lung injury scores, OSF, SOFA, and MOD scores than nonsurvivors. After HFOV, the OSF, SOFA, and MOD scores were significantly decreased for survivors, particularly from day 3 onward. Conclusions: Survivors had early improvements in OSF scores after HFOV application. Organ failure system scoring may be used for deciding on HFOV initiation and for evaluating the effects of HFOV.
引用
收藏
页码:1536 / 1542
页数:7
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