Abstract:
BACKGROUND:Patients with initial mild acute respiratory distress syndrome are often underrecognized and mistakenly considered to have low disease severity and favorable outcomes. They represent a relatively poorly characterized population that was only classified as having acute respiratory distress syndrome in the most recent definition. Our primary objective was to describe the natural course and the factors associated with worsening and mortality in this population. METHODS:This study analyzed patients from the international prospective Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) who had initial mild acute respiratory distress syndrome in the first day of inclusion. This study defined three groups based on the evolution of severity in the first week: "worsening" if moderate or severe acute respiratory distress syndrome criteria were met, "persisting" if mild acute respiratory distress syndrome criteria were the most severe category, and "improving" if patients did not fulfill acute respiratory distress syndrome criteria any more from day 2. RESULTS:Among 580 patients with initial mild acute respiratory distress syndrome, 18% (103 of 580) continuously improved, 36% (210 of 580) had persisting mild acute respiratory distress syndrome, and 46% (267 of 580) worsened in the first week after acute respiratory distress syndrome onset. Global in-hospital mortality was 30% (172 of 576; specifically 10% [10 of 101], 30% [63 of 210], and 37% [99 of 265] for patients with improving, persisting, and worsening acute respiratory distress syndrome, respectively), and the median (interquartile range) duration of mechanical ventilation was 7 (4, 14) days (specifically 3 [2, 5], 7 [4, 14], and 11 [6, 18] days for patients with improving, persisting, and worsening acute respiratory distress syndrome, respectively). Admissions for trauma or pneumonia, higher nonpulmonary sequential organ failure assessment score, lower partial pressure of alveolar oxygen/fraction of inspired oxygen, and higher peak inspiratory pressure were independently associated with worsening. CONCLUSIONS:Most patients with initial mild acute respiratory distress syndrome continue to fulfill acute respiratory distress syndrome criteria in the first week, and nearly half worsen in severity. Their mortality is high, particularly in patients with worsening acute respiratory distress syndrome, emphasizing the need for close attention to this patient population.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Pham T,Serpa Neto A,Pelosi P,Laffey JG,De Haro C,Lorente JA,Bellani G,Fan E,Brochard LJ,Pesenti A,Schultz MJ,Artigas A,LUNG SAFE Investigators* and the European Society of Intensive Care Medicine Trials Group.doi
10.1097/ALN.0000000000002508subject
Has Abstractpub_date
2019-02-01 00:00:00pages
263-283issue
2eissn
0003-3022issn
1528-1175journal_volume
130pub_type
杂志文章,多中心研究相关文献
ANESTHESIOLOGY文献大全abstract:BACKGROUND:The permutation entropy, the approximate entropy, and the index of consciousness are some of the most recently studied electroencephalogram-derived indexes. In this work, a thorough comparison of these indexes was performed using propofol anesthesia in a rabbit model. METHODS:Six rabbits were anesthetized w...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e318222ac02
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:The current study was performed to determine whether volatile anesthetics may include as part of their action in the central nervous system the depression of presynaptic transmitter release by alteration in intrasynaptic [Ca2+] ([Ca2+]i). METHODS:Guinea pig cerebrocortical synaptosomes were studied at 37 de...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199509000-00019
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:In cardiac myocytes, lidocaine reduces but mexiletine increases adenosine triphosphate (ATP)-sensitive K+ currents, suggesting that these class Ib antiarrhythmic drugs may differentially modify the activity of ATP-sensitive K+ channels. The effects of lidocaine and mexiletine on arterial relaxations induced ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199904000-00032
更新日期:1999-04-01 00:00:00
abstract:BACKGROUND:The neural mechanisms underlying the modulation of pain perception by hypnosis remain obscure. In this study, we used positron emission tomography in 11 healthy volunteers to identify the brain areas in which hypnosis modulates cerebral responses to a noxious stimulus. METHODS:The protocol used a factorial ...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-200005000-00013
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Postoperative visual loss after prone spine surgery is increasingly reported in association with ischemic optic neuropathy, but its etiology is unknown. METHODS:To describe the clinical characteristics of these patients, the authors analyzed a retrospectively collected series of 93 spine surgery cases volun...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200610000-00007
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Sevoflurane is a volatile general anesthetic that differs in chemical nature from the gaseous anesthetic nitrous oxide. In a controlled laboratory setting, the authors characterized the subjective, psychomotor, and analgesic effects of sevoflurane and nitrous oxide at two equal minimum alveolar subanesthetic...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-199711000-00012
更新日期:1997-11-01 00:00:00
abstract::Neomycin and polymyxin B produce neuromuscular blocks with distinct features by different mechanisms of action. In eight anesthetized cats the authors studied their interaction by examining the neuromuscular block produced by an equipotent mixture. Values of onset, potency, dose-response relations, duration and revers...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197903000-00010
更新日期:1979-03-01 00:00:00
abstract:BACKGROUND:High-fidelity simulation is known to improve participant learning and behavioral performance. Simulation scenarios generate stress that affects memory retention and may impact future performance. The authors hypothesized that more participants would recall three or more critical key messages at three months ...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0000000000002045
更新日期:2018-03-01 00:00:00
abstract::The authors studied anesthetic mutagenesis following exposure in vivo by use of an adaptation of the mouse spermatozoa morphology assay of Wyrobek and Bruce. The epididymal spermatozoa of (C57B1/C3H)F1 mice were examined for morphologic abnormalities following exposure to near-0.1 MAC and greater concentrations of gen...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198101000-00010
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Spontaneous breaths during airway pressure release ventilation (APRV) have to overcome the resistance of the artificial airway. Automatic tube compensation provides ventilatory assistance by increasing airway pressure during inspiration and lowering airway pressure during expiration, thereby compensating for...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200108000-00020
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:The effects of thoracic epidural anesthesia (TEA) on myocardial repolarization and arrhythmogenicity are only incompletely understood. This is primarily because of the lack of appropriate experimental models. In most of the studies performed thus far, TEA was used in anesthetized animals. Baseline anesthesia...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200107000-00023
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Isoflurane induces cell apoptosis by an unknown mechanism. The authors hypothesized that isoflurane activates inositol 1,4,5-trisphosphate (IP3) receptors on the endoplasmic reticulum (ER) membrane, causing excessive calcium release, triggering apoptosis. METHODS:The authors determined isoflurane-induced cy...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/01.anes.0000299435.59242.0e
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Initial postoperative core temperature is a physician and hospital performance measure. However, the extent to which core temperature changes during emergence from anesthesia and transport from the operating room to the postanesthesia care unit (PACU) remains unknown. Similarly, the accuracy of many noninvas...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181a864ca
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Postoperative nausea and vomiting (PONV) occurs frequently after gynecologic surgery. Because hemodynamic condition seems to be influential, women presenting with preoperative orthostatic dysregulation may have an increased risk for PONV. The aim of the present study was to assess the relationship between pr...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200206000-00017
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:The authors recently established that the analgesic actions of the inhalation anesthetic nitrous oxide were mediated by noradrenergic bulbospinal neurons and spinal alpha2B adrenoceptors. They now determined whether noradrenergic brainstem nuclei and descending spinal pathways are responsible for the antinoc...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200202000-00023
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:Tracheal intubation frequently results in reversible bronchoconstriction. Propofol has been reported to minimize this response in healthy patients and in asthma patients, but may be unsuitable for hemodynamically unstable patients for whom etomidate may be preferable. The current study examined respiratory r...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199606000-00005
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Whether coronary steal is induced by inhaled anesthetic agents remains controversial in part because multiple factors determine collateral blood flow. METHODS:We used an established model to determine how halothane, isoflurane, and desflurane affect the hemodynamic determinants of coronary collateral blood ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199510000-00020
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:The anticonvulsant gabapentin, proven effective for neuropathic pain in two large, placebo-controlled clinical trials, is widely used for treatment of chronic pain. Preclinical studies have demonstrated analgesic and antiallodynic effects in models involving neuronal sensitization and nerve injury, without a...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200207000-00015
更新日期:2002-07-01 00:00:00
abstract::The authors investigated the value of high-dose thiopental (TH) therapy after 16-min complete global brain ischemia (GBI) in three groups of pigtailed monkeys, using a neck cuff model of GBI with 96 h intensive care postischemia (PI). Control group (n18): Normotension was restored within 2 min PI; paralysis/controlled...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198402000-00002
更新日期:1984-02-01 00:00:00
abstract:BACKGROUND:Propofol is widely used clinically for the induction and maintenance of anesthesia. Clinical case reports have shown that propofol has an antiatrial tachycardia/fibrillation effect; however, the related ionic mechanisms are not fully understood. The current study investigates the effects of propofol on human...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000495
更新日期:2015-03-01 00:00:00
abstract::The present study was designed to determine changes in hepatic oxygen supply in guinea pigs during halothane or isoflurane anesthesia. Twenty-seven guinea pigs were randomly divided into three equal groups: control (no anesthesia) group, and animals anesthetized with halothane or isoflurane to decrease mean arterial p...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198711000-00014
更新日期:1987-11-01 00:00:00
abstract::This study was performed to determine if direct arterial dilating actions of propofol contribute to the drug's hypotensive actions. The effects of propofol were compared with those of thiopental on isolated vascular ring preparations from rat thoracic aorta and pulmonary artery. Thoracic aortic ring responses were eva...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199211000-00019
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:Inhaled nitric oxide (NO), an endothelium-derived relaxing factor, is a selective pulmonary vasodilator. The authors investigated whether inhaled NO decreases pulmonary vascular resistance (PVR) while preserving hypoxic pulmonary vasoconstriction and whether it maintains or improves oxygenation in patients d...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:We evaluated whether spectral entropy (SpE) can measure the depth of hypnosis and the hypnotic drug effect in children during total intravenous anesthesia. METHODS:Sixty healthy children, aged 3-16 yr, were studied. Anesthesia was induced with an increasing target controlled infusion of propofol, and mainta...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3182410b5e
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:This series investigated the quality of analgesia and the incidence and severity of side effects of intrathecal morphine for post-cesarean analgesia administered over a dose range of 0.0-0.5 mg. METHODS:ONE hundred eight term parturients undergoing cesarean delivery at term and given spinal anesthesia were ...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199902000-00018
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:There is little information concerning the carbon dioxide-related effects on respiratory mechanics in anesthetized, paralyzed subjects; however, hypocapnia or hypercapnia is often permitted in patients with severe brain injury or acute respiratory distress syndrome. Therefore, the carbon dioxide dependence o...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200104000-00013
更新日期:2001-04-01 00:00:00
abstract::Although it generally is agreed that halothane is a pulmonary vasodilator, its effect on venous admixture and hypoxic pulmonary vasoconstriction are more controversial. The effects of 2.4% halothane on pulmonary vascular resistance and venous admixture were investigated in an isolated canine lobe made atelectatic. Hal...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199208000-00013
更新日期:1992-08-01 00:00:00
abstract:BACKGROUND:It should be possible to avoid variations in plasma glucose concentration during anesthesia by adjusting glucose infusion rate to whole-body glucose uptake. To study this hypothesis, we measured glucose utilization and production, before and during halothane anesthesia. METHODS:After an overnight fast, six ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199505000-00010
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:The hanging drop technique is used for identifying the cervical epidural space, using its negative pressure. However, it is doubtful whether the epidural space intrinsically exhibits a negative pressure. We designed this study to test the hypothesis that the cervical epidural pressure (CEP) is significantly ...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e3181e898e8
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Remifentanil anesthesia enhances postoperative pain in animals and humans. The authors evaluated the impact of the dose (microg x kg(-1) x min(-1)) and duration of remifentanil infusion, and the effects of a second surgery on postoperative pain sensitization. METHODS:Mice received different doses of remifen...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181bfab61
更新日期:2009-12-01 00:00:00