Citations 3
Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients From 29 Countries
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Pantoja, Papandreou, E., Papanikolaou, Metaxia, Patel, Mayur , Pavlek, Mario , Pedrotti, Niccolò , Hwa, Ngu Pei, Pelagalli, Lorella, Ruiz, Miryam Pérez, Persson, Elin, Petsiou, Athanasia, Philippard, Francois, Piegat, Mariusz, Pili‐Floury, Sébastien, Pinto, Márcia , Piton, Gaël , Plantefève, Gaëtan , Pouplet, Caroline, Pouriki, Sofia, Pradella, Andrea , Prashant, Kumar , Quayle, Alice, Rahmani, Lua S. , Randall, Ian , Ray, Banambar , Reza, Syed T., Ricard, Jean Damien, Riva, Ivano, Rona, Roberto , Rosell, Jon, Rowley, Rebecca, Rumschuessel, Kay, Rundo, Annalisa, Russo, Pierpaolo, Sahu, Samir, Salmon-Gandonnière, Charlotte, Roman, Nandyelly San Juan, Sandefur, Benjamin J. , Santoro, Lida, Sanyal, Rhik, Saravanabavan, Lakshmikanthcharan , Shah, Bhagyesh, Shah, Mehul , Shin, Ming-Hann, Simpson, Shannon, Sinah, Ayush, Singh, D. K., Singh, Nitesh , Singh, Lalit, Skowronski, Lukasz , Sosa, Miguel A. Gama , Spadaro, Savino , Spångfors, Martin , Sperber, Jesper , Spina, Rosario, Srivastava, Anand , Steel, Andrew, Suárez-de-la-Rica, Alejandro , Kumar, Singh Sujeet, Sundrani, Omprakash, Sunil, Nilu, Suparna, Bharadwaj, Surath, Manimala R., Syed, Yadullah, Sztrymf, Benjamin , Tarantino, Stefano, Tileli, Maria, Castro, Hugo Arturo Tirapé , Toledo-Salinas, Otoniel , Tramarin, Jacopo, Tsiftsis, D , Tucić, Iva , León, Jose A. Tutillo, Tutino, Lorenzo, Tyagi, Vijay, Vagdatli, Kyriaki, Varkey, Sneha, Vera, Magdalena , Seth, Magnus Von, Wahlström, C.-G., Ismail, Wan Nasrudin Wan, Winiszewski, Hadrien , Wu, Lun , Zani, Gianluca , Zarka, Jonathan , Zhao, Dawn, Zlotnik, Diane , Bauer, Philippe, Laffey, John G , Labarca, Gonzalo , Alhadi, Abdulmueti , Myatra, Sheila Nainan , Antolini, Laura , Bauer, Philippe R. , Lascarrou, Jean-Baptiste , Szuldrzynski, Konstanty S. , Pelosi, Paolo , Sorbello, Massimiliano , Greif, Robert , Chalkias, Athanasios F. , Pesenti, Antonio, Foti, Giuseppe , Bellani, Giacomo , Investigators, INTUBE Study, Agvald-Öhman, Christina, Ahmad, Meraj, Almekhlafi, Ghaleb A. , Aragão, Irene , Azoulay, Élie , Basto, Marta Lima , Besset, Sebastien, Boni, Elisa, Brazzi, Luca , Broman, Lina, Browne, Alexander, Cappellini, Iacopo , Chao, Anne , Chien, Jung‐Yien , Chou, Nai‐Kuan , Cortegiani, Andrea , Costamagna, Andrea , Cotoia, Antonella , Cracchiolo, Andrea N., Das, Amit, Rosa, Silvia De , Sorbo, Lorenzo Del , Fenza, Raffaele Di , Giacinto, Ida Di , Dudda, Marcel , Ehrentraut, Stefan , Elhadi, Muhammed , Fernandes, Marco, Flores, Fernando, Frat, Jean-Pierre , Fusari, Maurizio , Moraes, Alice Gallo de , Gammaldi, Renato , Gaszynski, Tomasz M , Godet, Thomas , Goffi, Alberto , González-Castro, A. , Guervilly, Christophe , Guitton, Christophe , Huang, Chun‐Kai , Jankowski, Miłosz , Jones, Laura, Karelov, Alexey, Katsoulis, P. , Kaye, Callum T. , Khalidah, Hapiz, Khan, Akram , Ku, Shih‐Chi , Kuo, Lu-Cheng , Lalwani, Jaya, Laserna, Andrés , Lee, Chien‐Chang , Legriel, Stéphane , Li, Yongxing , Licciardi, Anna Lisa, Litton, Edward , Ломиворотов, В. В. , Longhini, Federico , Магомедов, М. А. , Геннадьевна, Марова Надежда , Maseda, Emilio , Mastroianni, Fiore , Michálek, Pavel , Mishra, Prasanna, Mistry, Ravi, Montini, Luca , Montrucchio, Giorgia Giuseppina , Mosier, Jarrod , Mudyna, Wojciech, Müller, Grégoire , Munta, Kartik, Musso, Stefania, Nakou, Evi, Nates, Joseph L. , Nogueira, Carla, Leal, Jesús Nicolás Pantoja, Papandreou, Eleni, Parotto, Matteo , Persson, Elin, Pezzi, Angelo , Philip, Sam, Pinciroli, Riccardo , Pinto, Marcia, Pouplet, Caroline, Regli, Adrian , Roca, Oriol , Rosell, Jon, Ruan, Sheng‐Yuan , Sahu, Samir, Sales, Gabriele , Roman, Nandyelly San Juan, Sánchez‐Hurtado, Luis Alejandro , Santafe, Manel, Sanyal, Rhik, Shah, Bhagyesh, Silva, Monica, Simpson, Shannon, Singh, Atul Kumar , Singh, Lalit, Sosa, Miguel A., Srivastava, Anand, Szakmány, Tamás , Tabah, Alexis , León, José Andrés Tutillo , Wahlstrom, Carl, Hassan, Wan Mohd Nazaruddin Wan , Wang, Kuo‐Chuan , Wu, Jiayan , Yeh, Yu‐Chang , Young, Paul J.
JAMA | March 23, 2021 | Volume: 325 | Issue: 12 | Pages: 1164
Prediction of Opioid-Induced Respiratory Depression on Inpatient Wards Using Continuous Capnography and Oximetry: An International Prospective, Observational Trial
Uezono, Shoichi , Ti, Lian Kah , McIntyre, Robert C. , Tornero, Carlos , Dahan, Albert , Saager, Leif , Wittmann, Mária , Auckley, Dennis , Soto, Roy G. , Schramm, Frank, Ayad, Sabry , Kaw, Roop , Stefano, Paola Di, Moll, Vanessa , Dempsey, Susan J., Bühre, Wolfgang , Overdyk, Frank J. , Collaborators, on behalf of the PRediction of Opioid-induced respiratory Depression In patients monitored by capnoGraphY (PRODIGY) Group, Fiorda‐Diaz, Juan , Khanna, Ashish K. , Bergese, Sergio D. , Jungquist, Carla R. , Morimatsu, Hiroshi , Lee, Simon , Urman, Richard D , Weingarten, Toby N. , Brazzi, Luca , Guen, Morgan Le , Schramm, Frank, Sessler, Daniel I. , Uribe, Alberto A. , Collaborators, on behalf of the PRediction of Opioid-induced respiratory Depression In patients monitored by capnoGraphY (PRODIGY) Group, Law, Lawrence Siu‐Chun
Anesthesia & Analgesia | April 18, 2020 | Volume: 131 | Issue: 4 | Pages: 1012-1024
BACKGROUND: Opioid-related adverse events are a serious problem in hospitalized patients. Little is known about patients who are likely to experience opioid-induced respiratory depression events on the general care floor and may benefit from improved monitoring and early intervention. The trial objective was to derive and validate a risk prediction tool for respiratory depression in patients receiving opioids, as detected by continuous pulse oximetry and capnography monitoring. METHODS: PRediction of Opioid-induced respiratory Depression In patients monitored by capnoGraphY (PRODIGY) was a prospective, observational trial of blinded continuous capnography and oximetry conducted at 16 sites in the United States, Europe, and Asia. Vital signs were intermittently monitored per standard of care. A total of 1335 patients receiving parenteral opioids and continuously monitored on the general care floor were included in the analysis. A respiratory depression episode was defined as respiratory rate ≤5 breaths/min (bpm), oxygen saturation ≤85%, or end-tidal carbon dioxide ≤15 or ≥60 mm Hg for ≥3 minutes; apnea episode lasting >30 seconds; or any respiratory opioid-related adverse event. A risk prediction tool was derived using a multivariable logistic regression model of 46 a priori defined risk factors with stepwise selection and was internally validated by bootstrapping. RESULTS: One or more respiratory depression episodes were detected in 614 (46%) of 1335 general care floor patients (43% male; mean age, 58 ± 14 years) continuously monitored for a median of 24 hours (interquartile range [IQR], 17–26). A multivariable respiratory depression prediction model with area under the curve of 0.740 was developed using 5 independent variables: age ≥60 (in decades), sex, opioid naivety, sleep disorders, and chronic heart failure. The PRODIGY risk prediction tool showed significant separation between patients with and without respiratory depression ( P < .001) and an odds ratio of 6.07 (95% confidence interval [CI], 4.44–8.30; P < .001) between the high- and low-risk groups. Compared to patients without respiratory depression episodes, mean hospital length of stay was 3 days longer in patients with ≥1 respiratory depression episode (10.5 ± 10.8 vs 7.7 ± 7.8 days; P < .0001) identified using continuous oximetry and capnography monitoring. CONCLUSIONS: A PRODIGY risk prediction model, derived from continuous oximetry and capnography, accurately predicts respiratory depression episodes in patients receiving opioids on the general care floor. Implementation of the PRODIGY score to determine the need for continuous monitoring may be a first step to reduce the incidence and consequences of respiratory compromise in patients receiving opioids on the general care floor.
Noninvasive Ventilation of Patients with Acute Respiratory Distress Syndrome. Insights from the LUNG SAFE Study
Laffey, John G. , Pham, Tài , Madotto, Fabiana , Brochard, Laurent , Esteban, Andres, Gattinoni, Luciano , Bumbaširević, Vesna, Piquilloud, Lise , Haren, Frank van , Larsson, Anders, McAuley, Daniel F. , Arabi, Yaseen M. , Ranieri, Marco, Antonelli, Massimo , Rubenfeld, Gordon D., Wrigge, Hermann , Slutsky, Arthur S. , Schultz, Marcus J. , Bajwa, Ednan K. , Ferguson, Niall D. , Frendl, György , Brown, Samuel M. , Terzi, Nicolas , Brazzi, Luca , Montini, Luca , Tomescu, Dana , Lanspa, Michael J. , Almekhlafi, Ghaleb A. , Cortegiani, Andrea , Fusari, Maurizio , González-Castro, A. , Parotto, Matteo , Sánchez‐Hurtado, Luis Alejandro , Spadaro, Savino , Szakmány, Tamás , Zani, Gianluca , Bihari, Shailesh , Laffey, John G , Bellani, Giacomo , Fan, Eddy , Esteban, Andres, Bauer, Philippe R. , Thompson, Bruce , Pesenti, Antonio Maria , Schultz, Marcus J , Arabi, Yaseen M
American Journal of Respiratory and Critical Care Medicine | October 18, 2016 | Volume: 195 | Issue: 1 | Pages: 67-77
Abstract Rationale Noninvasive ventilation (NIV) is increasingly used in patients with acute respiratory distress syndrome (ARDS). The evidence supporting NIV use in patients with ARDS remains relatively sparse. Objectives To determine whether, during NIV, the categorization of ARDS severity based on the PaO2/FiO2 Berlin criteria is useful. Methods The LUNG SAFE (Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure) study described the management of patients with ARDS. This substudy examines the current practice of NIV use in ARDS, the utility of the PaO2/FiO2 ratio in classifying patients receiving NIV, and the impact of NIV on outcome. Measurements and Main Results Of 2,813 patients with ARDS, 436 (15.5%) were managed with NIV on Days 1 and 2 following fulfillment of diagnostic criteria. Classification of ARDS severity based on PaO2/FiO2 ratio was associated with an increase in intensity of ventilatory support, NIV failure, and intensive care unit (ICU) mortality. NIV failure occurred in 22.2% of mild, 42.3% of moderate, and 47.1% of patients with severe ARDS. Hospital mortality in patients with NIV success and failure was 16.1% and 45.4%, respectively. NIV use was independently associated with increased ICU (hazard ratio, 1.446 [95% confidence interval, 1.159–1.805]), but not hospital, mortality. In a propensity matched analysis, ICU mortality was higher in NIV than invasively ventilated patients with a PaO2/FiO2 lower than 150 mm Hg. Conclusions NIV was used in 15% of patients with ARDS, irrespective of severity category. NIV seems to be associated with higher ICU mortality in patients with a PaO2/FiO2 lower than 150 mm Hg. Clinical trial registered with www.clinicaltrials.gov (NCT 02010073).