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Villar, Jesús; Mora-Ordoñez, Juan M.; Soler, Juan A.; Mosteiro, Fernando; Vidal, Anxela; Ambrós, Alfonso; Fernández, Lorena; Murcia, Isabel; Civantos, Belén; Romera, Miguel A.; Mira, Adrián; Díaz-Domínguez, Francisco J.; Parrilla, Dácil; Martínez-Carmona, J. Francisco; Martínez, Domingo; Pita-García, Lidia; Robaglia, Denis; Bueno-González, Ana; Sánchez-Ballesteros, Jesús; Pereyra, Ángel E.; Hernández, Mónica; Chamorro-Jambrina, Carlos; Cobeta, Pilar; González-Luengo, Raúl I.; [...]

The PANDORA Study: Prevalence and Outcome of Acute Hypoxemic Respiratory Failure in the Pre-COVID-19 Era

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  • Media type: E-Article
  • Title: The PANDORA Study: Prevalence and Outcome of Acute Hypoxemic Respiratory Failure in the Pre-COVID-19 Era
  • Contributor: Villar, Jesús; Mora-Ordoñez, Juan M.; Soler, Juan A.; Mosteiro, Fernando; Vidal, Anxela; Ambrós, Alfonso; Fernández, Lorena; Murcia, Isabel; Civantos, Belén; Romera, Miguel A.; Mira, Adrián; Díaz-Domínguez, Francisco J.; Parrilla, Dácil; Martínez-Carmona, J. Francisco; Martínez, Domingo; Pita-García, Lidia; Robaglia, Denis; Bueno-González, Ana; Sánchez-Ballesteros, Jesús; Pereyra, Ángel E.; Hernández, Mónica; Chamorro-Jambrina, Carlos; Cobeta, Pilar; González-Luengo, Raúl I.; [...]
  • Published: Ovid Technologies (Wolters Kluwer Health), 2022
  • Published in: Critical Care Explorations, 4 (2022) 5, Seite e0684
  • Language: English
  • DOI: 10.1097/cce.0000000000000684
  • ISSN: 2639-8028
  • Origination:
  • Footnote:
  • Description: OBJECTIVES: To establish the epidemiological characteristics, ventilator management, and outcomes in patients with acute hypoxemic respiratory failure (AHRF), with or without acute respiratory distress syndrome (ARDS), in the era of lung-protective mechanical ventilation (MV). DESIGN: A 6-month prospective, epidemiological, observational study. SETTING: A network of 22 multidisciplinary ICUs in Spain. PATIENTS: Consecutive mechanically ventilated patients with AHRF (defined as Pao 2/Fio 2 ≤ 300 mm Hg on positive end-expiratory pressure [PEEP] ≥ 5 cm H2O and Fio 2 ≥ 0.3) and followed-up until hospital discharge. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Primary outcomes were prevalence of AHRF and ICU mortality. Secondary outcomes included prevalence of ARDS, ventilatory management, and use of adjunctive therapies. During the study period, 9,803 patients were admitted: 4,456 (45.5%) received MV, 1,271 (13%) met AHRF criteria (1,241 were included into the study: 333 [26.8%] met Berlin ARDS criteria and 908 [73.2%] did not). At baseline, tidal volume was 6.9 ± 1.1 mL/kg predicted body weight, PEEP 8.4 ± 3.1 cm H2O, Fio 2 0.63 ± 0.22, and plateau pressure 21.5 ± 5.4 cm H2O. ARDS patients received higher Fio 2 and PEEP than non-ARDS (0.75 ± 0.22 vs 0.59 ± 0.20 cm H2O and 10.3 ± 3.4 vs 7.7 ± 2.6 cm H2O, respectively [p < 0.0001]). Adjunctive therapies were rarely used in non-ARDS patients. Patients without ARDS had higher ventilator-free days than ARDS (12.2 ± 11.6 vs 9.3 ± 9.7 d; p < 0.001). All-cause ICU mortality was similar in AHRF with or without ARDS (34.8% [95% CI, 29.7–40.2] vs 35.5% [95% CI, 32.3–38.7]; p = 0.837). CONCLUSIONS: AHRF without ARDS is a very common syndrome in the ICU with a high mortality that requires specific studies into its epidemiology and ventilatory management. We found that the prevalence of ARDS was much lower than reported in recent observational studies.
  • Access State: Open Access