| Title |
Associations between ventilator settings during extracorporeal membrane oxygenation for refractory hypoxemia and outcome in patients with acute respiratory distress syndrome: a pooled individual patient data analysis
|
|---|---|
| Published in |
Intensive Care Medicine, September 2016
|
| DOI | 10.1007/s00134-016-4507-0 |
| Pubmed ID | |
| Authors |
Ary Serpa Neto, Matthieu Schmidt, Luciano C. P. Azevedo, Thomas Bein, Laurent Brochard, Gernot Beutel, Alain Combes, Eduardo L. V. Costa, Carol Hodgson, Christian Lindskov, Matthias Lubnow, Catherina Lueck, Andrew J. Michaels, Jose-Artur Paiva, Marcelo Park, Antonio Pesenti, Tài Pham, Michael Quintel, V. Marco Ranieri, Michael Ried, Roberto Roncon-Albuquerque, Arthur S. Slutsky, Shinhiro Takeda, Pier Paolo Terragni, Marie Vejen, Steffen Weber-Carstens, Tobias Welte, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J. Schultz |
| Abstract |
Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for patients with acute respiratory distress syndrome (ARDS). The aim of this study was to evaluate associations between ventilatory settings during ECMO for refractory hypoxemia and outcome in ARDS patients. In this individual patient data meta-analysis of observational studies in adult ARDS patients receiving ECMO for refractory hypoxemia, a time-dependent frailty model was used to determine which ventilator settings in the first 3 days of ECMO had an independent association with in-hospital mortality. Nine studies including 545 patients were included. Initiation of ECMO was accompanied by significant decreases in tidal volume size, positive end-expiratory pressure (PEEP), plateau pressure, and driving pressure (plateau pressure - PEEP) levels, and respiratory rate and minute ventilation, and resulted in higher PaO2/FiO2, higher arterial pH and lower PaCO2 levels. Higher age, male gender and lower body mass index were independently associated with mortality. Driving pressure was the only ventilatory parameter during ECMO that showed an independent association with in-hospital mortality [adjusted HR, 1.06 (95 % CI, 1.03-1.10)]. In this series of ARDS patients receiving ECMO for refractory hypoxemia, driving pressure during ECMO was the only ventilator setting that showed an independent association with in-hospital mortality. |
X Demographics
The data shown below were collected from the profiles of 18 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 4 | 22% |
| Australia | 2 | 11% |
| United States | 2 | 11% |
| Canada | 1 | 6% |
| Argentina | 1 | 6% |
| France | 1 | 6% |
| Italy | 1 | 6% |
| United Kingdom | 1 | 6% |
| Unknown | 5 | 28% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 10 | 56% |
| Practitioners (doctors, other healthcare professionals) | 4 | 22% |
| Science communicators (journalists, bloggers, editors) | 2 | 11% |
| Scientists | 2 | 11% |
Mendeley readers
The data shown below were compiled from readership statistics for 239 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | <1% |
| Canada | 1 | <1% |
| Unknown | 237 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 32 | 13% |
| Student > Doctoral Student | 28 | 12% |
| Other | 24 | 10% |
| Student > Ph. D. Student | 20 | 8% |
| Student > Master | 17 | 7% |
| Other | 63 | 26% |
| Unknown | 55 | 23% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 137 | 57% |
| Nursing and Health Professions | 17 | 7% |
| Engineering | 6 | 3% |
| Agricultural and Biological Sciences | 5 | 2% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | <1% |
| Other | 9 | 4% |
| Unknown | 63 | 26% |
Attention Score in Context
This research output has an Altmetric Attention Score of 18. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 November 2016.
All research outputs
#2,027,688
of 25,137,221 outputs
Outputs from Intensive Care Medicine
#1,620
of 5,362 outputs
Outputs of similar age
#34,728
of 345,765 outputs
Outputs of similar age from Intensive Care Medicine
#18
of 117 outputs
Altmetric has tracked 25,137,221 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,362 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 29.7. This one has gotten more attention than average, scoring higher than 69% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 345,765 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 89% of its contemporaries.
We're also able to compare this research output to 117 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 85% of its contemporaries.