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Browsing by Department "Anesteziyoloji & Reanimasyon Ana Bilim Dalı"

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    Six-month survival of patients with acute lung injury: Prospective cohort study
    (Lippincott Williams & Wilkins, 2007-10) Yılmaz, Murat; Keegan, Mark T.; Vlahakis, Nicholas E.; Afessa, Bekele; Hubmayr, Rolf D.; Gajic, Ognjen; İşçimen, Remzi; Tıp Fakültesi; Anesteziyoloji & Reanimasyon Ana Bilim Dalı; 0000-0001-8111-5958; AAI-8104-2021; 16645821200
    Objective: Both short- and long-term outcome studies in acute lung injury (ALI) performed thus far were conducted before the implementation of recent advances in mechanical ventilation and supportive care and/or in the context of clinical trials with restricted inclusion criteria. We sought to determine the outcome of consecutive acute lung injury patients after the implementation of these interventions. Design: Prospective cohort study. Setting: Three intensive care units of two tertiary care hospitals. Patients: Patients with acute lung injury treated from October 2005 to May 2006, excluding those with no research authorization or do-not-resuscitate order. Interventions: None. Measurements and Main Results: The investigators collected detailed information about comorbidities, severity of pulmonary and nonpulmonary organ failures, complications, respiratory support, and other interventions. The main outcome measure was mortality 6 months after the onset of acute lung injury. From 142 patents enrolled over a 6-month period, 24 (17%) died in the intensive care unit, 38 (27%) in the hospital, and 55 (39%) by the end of the 6-month follow-up. Median (interquartile range) intensive care unit length of stay, duration of mechanical ventilation, and number of day 28 ventilator-free days were 7.1 (3.6-11.3), 5.7 (2.6-10.3), and, 19.0 (0-24.2) days. Multiple logistic regression analysis identified underlying Charlson comorbidity score (odds ratio 3.11, 95% confidence interval 2.01-5.05) for each point increase, transfer admission from the floor or outside hospital (odds ratio 3.75, 95% confidence interval 1.41-10.99), day 3 cardiovascular failure (odds ratio 3.30, 95% confidence interval 1.19-9.92), and day 3 Pao2/Fio2 (odds ratio 0.94,95% confidence interval 0.88-0.99) as significant predictors of 6-month mortality. Conclusions: With the implementation of recent advances in mechanical ventilation and supportive care, premorbid condition is the most important determinant of acute lung injury survival