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First tidal volume greater than 8 mL/kg is associated with increased mortality in complicated influenza infection with acute respiratory distress syndrome
Copyright policy )First tidal volume greater than 8 mL/kg is associated with increased mortality in complicated influenza infection with acute respiratory distress syndrome
Backgrounds: Severe influenza infection causes substantial morbidity and mortality worldwide and remains an important threat to global health. This study addressed factors related to treatment outcomes in subjects of complicated influenza infection with acute respiratory distress syndrome (ARDS) during the Taiwan epidemic in the Spring of 2016. Methods: This is a retrospective study conducted by Taiwan Severe Influenza Research Consortium (TSIRC), including eight tertiary referral medical centers. Patients with virology-proven influenza infection admitted to intensive care unit (ICU) between January and March 2016 were included for analysis. Results: We identified 263 patients with complicated influenza infection who fulfilled ARDS criteria; the mean age was 59.8 ± 14.6 (years), and 66.1% (166/263) were male. Type A influenza (77.9%, 205/263) virus was the main pathogen during this epidemic. The 30-day mortality rate was 23.2% (61/263). The mean tidal volume (VT) in the first three days after intubation was greater than 8 mL/kg of predicted body weight (PBW). Patients whose first measured VT was >8 mL/kg PBW had an increased 30-day mortality (p = 0.04, log-rank test). In a multivariate Cox proportional hazard regression model, an increase of 1 mL/kg PBW of first VT was associated with 26.1% increase in 30-day mortality (adjusted hazard ratio 1.261, 95% confidence interval [CI] 1.072–1.484, p < 0.01). Conclusion: First tidal volume, shortly after intubation, greater than 8 mL/kg PBW is an independent risk factor for mortality in complicated influenza infection with ARDS. Timely recognition of ARDS with strict adherence to protective ventilation strategy of lowering VT may be important in reducing mortality. Keywords: Influenza, Acute respiratory distress syndrome, Tidal volume
Microsoft Academic Graph classification: ARDS medicine.medical_specialty law.invention law Internal medicine medicine Risk factor Tidal volume business.industry Mortality rate Hazard ratio Retrospective cohort study medicine.disease Intensive care unit Confidence interval business
Library of Congress Subject Headings: lcsh:R5-920 lcsh:Medicine (General)
Male, Time Factors, Taiwan, Kaplan-Meier Estimate, Severity of Illness Index, Positive-Pressure Respiration, Risk Factors, Influenza, Human, Tidal Volume, Humans, Lung, Aged, Proportional Hazards Models, Retrospective Studies, Respiratory Distress Syndrome, General Medicine, Middle Aged, Intensive Care Units, Multivariate Analysis, Female
Male, Time Factors, Taiwan, Kaplan-Meier Estimate, Severity of Illness Index, Positive-Pressure Respiration, Risk Factors, Influenza, Human, Tidal Volume, Humans, Lung, Aged, Proportional Hazards Models, Retrospective Studies, Respiratory Distress Syndrome, General Medicine, Middle Aged, Intensive Care Units, Multivariate Analysis, Female
Microsoft Academic Graph classification: ARDS medicine.medical_specialty law.invention law Internal medicine medicine Risk factor Tidal volume business.industry Mortality rate Hazard ratio Retrospective cohort study medicine.disease Intensive care unit Confidence interval business
Library of Congress Subject Headings: lcsh:R5-920 lcsh:Medicine (General)
citations This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).11 popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.Top 10% influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).Average impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.Top 10% citations This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).11 popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.Top 10% influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).Average impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.Top 10%
Citations provided by BIP!Popularity provided by BIP!- National Taiwan University of Arts Taiwan
- Chang Gung University Taiwan
- Chang Gung University of Science and Technology Taiwan
- China Medical University Hospital Taiwan
- Kaohsiung Medical University Taiwan
- St. Michael's Hospital Canada
- National University Sudan
- Taipei Veterans General Hospital Taiwan
- National Taiwan University Hospital Taiwan
- Central Taiwan University of Science and Technology Taiwan
- Taichung Veterans General Hospital Taiwan
- Keelung Chang Gung Memorial Hospital Taiwan
- National Defense Medical Center Taiwan
- China Medical University Taiwan
- Tri-Service General Hospital Taiwan
- Kaohsiung Medical University Chung-Ho Memorial Hospital Taiwan
- University of Toronto Canada
Backgrounds: Severe influenza infection causes substantial morbidity and mortality worldwide and remains an important threat to global health. This study addressed factors related to treatment outcomes in subjects of complicated influenza infection with acute respiratory distress syndrome (ARDS) during the Taiwan epidemic in the Spring of 2016. Methods: This is a retrospective study conducted by Taiwan Severe Influenza Research Consortium (TSIRC), including eight tertiary referral medical centers. Patients with virology-proven influenza infection admitted to intensive care unit (ICU) between January and March 2016 were included for analysis. Results: We identified 263 patients with complicated influenza infection who fulfilled ARDS criteria; the mean age was 59.8 ± 14.6 (years), and 66.1% (166/263) were male. Type A influenza (77.9%, 205/263) virus was the main pathogen during this epidemic. The 30-day mortality rate was 23.2% (61/263). The mean tidal volume (VT) in the first three days after intubation was greater than 8 mL/kg of predicted body weight (PBW). Patients whose first measured VT was >8 mL/kg PBW had an increased 30-day mortality (p = 0.04, log-rank test). In a multivariate Cox proportional hazard regression model, an increase of 1 mL/kg PBW of first VT was associated with 26.1% increase in 30-day mortality (adjusted hazard ratio 1.261, 95% confidence interval [CI] 1.072–1.484, p < 0.01). Conclusion: First tidal volume, shortly after intubation, greater than 8 mL/kg PBW is an independent risk factor for mortality in complicated influenza infection with ARDS. Timely recognition of ARDS with strict adherence to protective ventilation strategy of lowering VT may be important in reducing mortality. Keywords: Influenza, Acute respiratory distress syndrome, Tidal volume