Ventilator Parameters in the Diagnosis and Prognosis of Acute Respiratory Distress Syndrome in Postoperative Patients: A Preliminary Study
Abstract
:1. Introduction
2. Objective
3. Material and Methods
3.1. Study Design
3.2. Ventilator Parameters
3.3. Statistical Analysis
4. Results
5. Discussion
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
References
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Variables | Non-ARDS (n = 11) | ARDS (n = 21) | p |
---|---|---|---|
General characteristics | |||
Age (years) | 61 ± 8 | 60 ± 17 | 0.687 |
Gender (M/F) | 5/6 | 17/4 | 0.056 |
BH (cm) | 158.5 ± 10.3 | 164.7 ± 6.9 | 0.050 |
BW (kg) | 65.6 ± 9.4 | 65.1 ± 8.5 | 0.882 |
BMI (kg/m2) | 26.3 ± 4.4 | 24.0 ± 2.8 | 0.138 |
Clinical characteristics | |||
Lung cancer/esophageal cancer | 6/5 | 9/5 | 0.697 |
SICU stay (days) | 4 (2, 4) | 25 (14, 36) | <0.001 * |
Pneumonia (yes/no) | 0/11 | 4/17 | 0.272 |
Hypertension (yes/no) | 3/8 | 4/17 | 0.667 |
ASA classification | 1 (1, 2) | 2 (2, 3) | 0.005 * |
APACHE II | 9 (6, 12) | 16 (11, 19) | 0.002 * |
RASS | 0 (0, 0) | −1 (−1, 0) | 0.001 * |
Ventilator parameters | |||
Endo size | 7 (7, 7.5) | 7.5 (7, 7.5) | 0.134 |
PEEP (cmH2O) | 5.8 ± 1.8 | 10.4 ± 3.0 | <0.001 * |
PIP (cmH2O) | 20 (20, 20) | 20 (18, 22) | 0.983 |
RI (s) | 5.0 (4.6, 5.0) | 3.5 (2.3, 3.8) | <0.001 * |
Ti (s) | 0.9 (0.9, 1.0) | 0.9 (0.8, 1.0) | 0.532 |
Te (s) | 3.8 ± 0.6 | 2.3 ± 0.9 | <0.001 * |
(mL/s) | 574.8 ± 92.5 | 464.7 ± 119.1 | 0.012 * |
VT (mL) | 538.5 ± 93.8 | 427 ± 117.4 | 0.011 * |
RR (bpm) | 12 (12, 13) | 17 (16, 26) | <0.001 * |
MV (L/min) | 7.1 ± 2.0 | 8.6 ± 3.2 | 0.160 |
Cdyn (mL/cmH2O) | 28.6 ± 6.2 | 22.9 ± 7.6 | 0.041 * |
Raw (cmH2O·s/mL) | 0.034 ± 0.006 | 0.044 ± 0.012 | 0.020 * |
RSBIv (bpm/L) | 25.0 (20.3, 26.1) | 56.3 (37.7, 69.6) | <0.001 * |
RPPv (cmH2O * bpm) | 240 (240, 260) | 340 (300, 540) | 0.010 * |
RPVI (cmH2O * bpm/mL) | 0.48 (0.39, 0.52) | 0.98 (0.71, 1.35) | 0.001 * |
IER | 0.24 (0.22, 0.25) | 0.36 (0.32, 0.66) | <0.001 * |
MW (cmH2O * L) | 10.3 ± 2.1 | 8.2 ± 2.6 | 0.030 * |
MW/IER (cmH2O * L) | 41.1 (37.0, 43.7) | 18.7 (12.8, 27.3) | <0.001 * |
Outcome | |||
Survivors | 11 (100%) | 16 (76.2%) | 0.138 |
Non-survivors | 0 (0%) | 5 (23.8%) |
Variables | Survivors (n = 16) | Non-survivors (n = 5) | p |
---|---|---|---|
General characteristics | |||
Age (years) | 57 ± 17 | 69 ± 12 | 0.148 |
Gender (M/F) | 14/2 | 3/2 | 0.228 |
BH (cm) | 165.3 ± 6.6 | 162.7 ± 8.3 | 0.493 |
BW (kg) | 64.5 ± 7.6 | 67.2 ± 11.6 | 0.546 |
BMI (kg/m2) | 23.62 ± 2.49 | 25.34 ± 3.49 | 0.235 |
Clinical characteristics | |||
Lung cancer/esophageal cancer | 5/4 | 4/1 | 0.123 |
ICU stay (days) | 20.5 (11, 40.5) | 25 (25, 36) | 0.509 |
Pneumonia (yes/no) | 4/12 | 0/5 | 0.532 |
ASA classification | 2 (2, 3) | 2 (2, 3) | 0.768 |
APACHE II | 14 (10, 19) | 18 (14, 29) | 0.185 |
LIS | 13 (10, 14) | 13 (12, 15) | 0.557 |
SOFA score | 8 (7, 10) | 7 (7, 8) | 0.313 |
RASS | −1 (−1, 0) | −2 (−2, −1) | 0.040 * |
WBC (×103/μL) | 13.3 (7.7, 13.4) | 12.9 (11.1, 14.0) | 0.905 |
CRP (mg/dL) | 21.5 (10.9, 22.6) | 12.4 (11.0, 19.7) | 0.495 |
Ventilator parameters | |||
Endo size | 7.5 (7.0, 7.5) | 7.0 (7.0, 7.5) | 0.314 |
PEEP (cmH2O) | 10.0 (9.0, 12.0) | 10.2 (10.0, 11.9) | 0.523 |
PIP (cmH2O) | 18 (15.5, 20) | 22 (20, 22) | 0.035 * |
RI (s) | 3.41 ± 0.94 | 2.58 ± 0.66 | 0.087 |
Ti (s) | 0.9 (0.8,1.0) | 0.9 (0.8,0.9) | 0.520 |
Te (s) | 2.48 ± 0.88 | 1.70 ± 0.70 | 0.088 |
VT (mL) | 436.3 ± 119.5 | 397.2 ± 117.9 | 0.530 |
RR (breaths/min) | 17 (16, 22) | 26 (24, 27) | 0.145 |
MV (L/min) | 8.19 ± 2.84 | 9.96 ± 4.08 | 0.285 |
RSBIv (bpm/L) | 47.8 ± 20.0 | 62.9 ± 10.4 | 0.045 * |
RPPv (cmH2O * bpm) | 359.5 ± 148.9 | 514.8 ± 92.7 | 0.042 * |
RPVI (cmH2O * bpm/mL) | 0.88 ± 0.39 | 1.35 ± 0.24 | 0.023 * |
Cdyn (mL/cmH2O) | 21.6 (18.9, 30.7) | 19.0 (17.7, 21.3) | 0.215 |
(mL/s) | 470.3 ± 122.1 | 446.9 ± 120.3 | 0.712 |
Raw (cmH2O·s/mL) | 0.041 ± 0.010 | 0.051 ± 0.017 | 0.105 |
MW (cmH2O * L) | 8.11 ± 2.72 | 8.46 ± 2.54 | 0.801 |
IER | 0.35 (0.32, 0.45) | 0.66 (0.60, 0.67) | 0.230 |
MW/IER (cmH2O * L) | 21.7 (12.2, 30.3) | 12.9 (12.8, 18.1) | 0.240 |
Variables | AUC Analysis | Principal Component Analysis | |
---|---|---|---|
Component 1 | Component 2 | ||
PEEP (cmH2O) | 0.931 | 0.760 | 0.327 |
RSBIv (bpm/L) | 0.885 | 0.992 | 0.041 |
RPVI (cmH2O * bpm/mL) | 0.857 | 0.949 | −0.091 |
MW/IER (cmH2O * L) | 0.944 | 0.877 | −0.025 |
RR (breaths/min) | 0.881 | 0.828 | −0.554 |
RI (s) | 0.881 | 0.828 | −0.554 |
Te (s) | 0.907 | 0.808 | −0.577 |
IER (per 0.1 increment) | 0.905 | 0.759 | −0.578 |
RPPv (cmH2O * bpm) | 0.779 | 0.743 | −0.587 |
Raw (cmH2O·s/mL)(per 0.01 increment) | 0.788 | 0.695 | 0.576 |
Cdyn (mL/cmH2O) | 0.784 | 0.686 | 0.511 |
(mL/s) | 0.801 | 0.603 | 0.755 |
MW (cmH2O * L) | 0.639 | 0.504 | 0.753 |
VT (mL) | 0.816 | 0.677 | 0.729 |
Significant Predictors of the Development of ARDS | ||||||
Variables | Model 1a | Model 2a | Model 3a | |||
Adj. OR | p | Adj. OR | p | Adj. OR | p | |
MW/IER | 0.82 (0.71, 0.94) | 0.004 * | 0.81 (0.70, 0.95) | 0.008 * | ||
VT | 0.99 (0.98, 1.00) | 0.033 * | 1.00 (0.99, 1.01) | 0.651 | ||
Predictors of Mortality in Patients with ARDS | ||||||
Variables | Model 1b | Model 2b | Model 3b | |||
Adj. OR | p | Adj. OR | p | Adj. OR | p | |
PIP | 1.35 (0.90, 2.02) | 0.150 | ||||
RSBIv | 1.05 (0.98, 1.13) | 0.190 | ||||
RPPv | 1.01 (1.00, 1.02) | 0.090 | ||||
RPVI | 28.4 (0.8, 1034.8) | 0.068 |
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Kor, C.-T.; Lin, K.-H.; Wang, C.-H.; Lin, J.-F.; Kuo, C.-D. Ventilator Parameters in the Diagnosis and Prognosis of Acute Respiratory Distress Syndrome in Postoperative Patients: A Preliminary Study. Diagnostics 2021, 11, 648. https://doi.org/10.3390/diagnostics11040648
Kor C-T, Lin K-H, Wang C-H, Lin J-F, Kuo C-D. Ventilator Parameters in the Diagnosis and Prognosis of Acute Respiratory Distress Syndrome in Postoperative Patients: A Preliminary Study. Diagnostics. 2021; 11(4):648. https://doi.org/10.3390/diagnostics11040648
Chicago/Turabian StyleKor, Chew-Teng, Kai-Huang Lin, Chen-Hsu Wang, Jui-Feng Lin, and Cheng-Deng Kuo. 2021. "Ventilator Parameters in the Diagnosis and Prognosis of Acute Respiratory Distress Syndrome in Postoperative Patients: A Preliminary Study" Diagnostics 11, no. 4: 648. https://doi.org/10.3390/diagnostics11040648