Details

Autor(en) / Beteiligte

• Blanchard, Florian
• Godet, Thomas
• Pons, Stephanie
• Kapandji, Natacha
• Jabaudon, Matthieu
• Degos, Vincent
• Borao, Lucile
• Bougle, Adrien
• Monsel, Antoine
• Futier, Emmanuel
• Constantin, Jean-Michel
• James, Arthur

Titel

One-year patient outcomes based on lung morphology in acute respiratory distress syndrome: secondary analysis of LIVE trial

Ist Teil von

• Critical care (London, England), 2022-06, Vol.26 (1), p.159-159, Article 159

Ort / Verlag

England: BioMed Central Ltd

Erscheinungsjahr

2022

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Acute respiratory distress syndrome (ARDS) has different phenotypes and distinct short-term outcomes. Patients with non-focal ARDS have a higher short-term mortality than focal ones. The aim of this study was to assess the impact of the morphological phenotypes of ARDS on long-term outcomes. This was a secondary analysis of the LIVE study, a prospective, randomised control trial, assessing the usefulness of a personalised ventilator setting according to lung morphology in moderate-to-severe ARDS. ARDS was classified as focal (consolidations only in the infero-posterior part of the lungs) or non-focal. Outcomes were assessed using mortality and functional scores for quality of life at the 1-year follow-up. A total of 124 focal ARDS and 236 non-focal ARDS cases were included. The 1-year mortality was higher for non-focal ARDS than for focal ARDS (37% vs. 24%, p = 0.012). Non-focal ARDS (hazard ratio, 3.44; 95% confidence interval, 1.80-6.59; p < 0.001), age, McCabe score, haematological cancers, SAPS II, and renal replacement therapy were independently associated with 1-year mortality. This difference was driven by mortality during the first 90 days (28 vs. 16%, p = 0.010) but not between 90 days and 1 year (7 vs. 6%, p = 0.591), at which point only the McCabe score was independently associated with mortality. Morphological phenotypes had no impact on patient-reported outcomes. Lung morphologies reflect the acute phase of ARDS and its short-term impact but not long-term outcomes, which seem only influenced by comorbidities. NCT02149589; May 29, 2014.