Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: How indices specific to respiratory compromise contribute to prognostication in patients with ARDS is not well characterized in general clinical populations. The primary objective of this study was to identify variables specific to respiratory failure that might add prognostic value to indicators of systemic illness severity in an observational cohort of subjects with ARDS.
Methods: Fifty subjects with ARDS were enrolled in a single-center, prospective, observational cohort. We tested the contribution of respiratory variables (oxygenation index, ventilatory ratio [VR], and the radiographic assessment of lung edema score) to logistic regression models of 28-d mortality adjusted for indicators of systemic illness severity (the Acute Physiology and Chronic Health Evaluation [APACHE] III score or severity of shock as measured by the number of vasopressors required at baseline) using likelihood ratio testing. We also compared a model utilizing APACHE III with one including baseline number of vasopressors by comparing the area under the receiver operating curve (AUROC).
Results: VR significantly improved model performance by likelihood ratio testing when added to APACHE III ( = .036) or the number of vasopressors at baseline ( = .01). Number of vasopressors required at baseline had similar prognostic discrimination to the APACHE III. A model including the number of vasopressors and VR (AUROC 0.77 [95% CI 0.64-0.90]) was comparable to a model including APACHE III and VR (AUROC 0.81 [95% CI 0.68-0.93]; for comparison = .58.).
Conclusions: In this observational cohort of subjects with ARDS, the VR significantly improved discrimination for mortality when combined with indicators of severe systemic illness. The number of vasopressors required at baseline and APACHE III had similar discrimination for mortality when combined with VR. VR is easily obtained at the bedside and offers promise for clinical prognostication.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9994339 | PMC |
| http://dx.doi.org/10.4187/respcare.09854 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Anaesthetic management and incidence of anaesthetic complications in dogs undergoing balloon valvuloplasty for treatment of pulmonic stenosis: a retrospective study.
Front Vet Sci
August 2025
Royal Veterinary College (RVC), London, United Kingdom.
A retrospective analysis of dogs undergoing balloon valvuloplasty of the pulmonic valve between April 2014 and March 2023 was performed. Anaesthetic records from 44 dogs were included in the analysis. Dogs were grouped according to anaesthetic maintenance agent used, inhalational agent with partial intravenous anaesthesia (PIVA, = 31) or propofol total intravenous anaesthesia (TIVA, = 13).
View Article and Find Full Text PDFRelationship between reported dose and outcome in amlodipine exposures: a 25-year retrospective poison center review.
Clin Toxicol (Phila)
August 2025
Department of Emergency Medicine, Oregon Health & Science University, Portland, OR, USA.
Introduction: Amlodipine, a dihydropyridine calcium channel blocker, is a growing cause of poisoning fatalities in the United States. As it takes several hours following ingestion for amlodipine peak plasma concentrations to be reached, the severity of poisoning may not be immediately apparent to clinicians. This study aimed to stratify reported amlodipine exposure doses with the severity of clinical outcomes.
View Article and Find Full Text PDFManaging penicillin resistant pneumococcal meningitis: an international id-iri study.
Eur J Clin Microbiol Infect Dis
September 2025
Department of Health Promotion, Maternal Childhood, Internal Medicine of Excellence G. D'Alessandro, University of Palermo, Palermo, Italy.
Penicillin-resistant pneumococcal meningitis (PRPM) is a challenging and fatal infection. We conducted a multicentre international retrospective study to evaluate the clinical features, outcomes, predictors of outcomes antimicrobial efficacy and drug susceptibility in patients with PRPM. The study, conducted through the "Infectious Diseases-International Research Initiative" across 33 centers in 11 countries, analyzed PRPM patients treated between 2019 and 2024 using univariate and multivariate analyses.
View Article and Find Full Text PDFAT receptors play a role in sepsis-induced vasoplegia by increasing iNOS expression in the perivascular adipose tissue.
Pflugers Arch
August 2025
Laboratório de Farmacologia Cardiovascular, Departamento de Ciências BioMoleculares, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, USP, Ribeirão Preto, São Paulo, Brazil.
Sepsis enhances the anticontractile effect of perivascular adipose tissue (PVAT), which contributes to a reduced response to vasoconstrictor agents. In the early stages of sepsis, the renin-angiotensin-aldosterone system (RAAS) is activated, and this response can lead to poorer clinical outcomes. We hypothesized that AT receptors (ATR) contribute to vascular hyporesponsiveness during sepsis by increasing the expression of inducible nitric oxide synthase (iNOS) in the periaortic PVAT, resulting in elevated nitric oxide (NO) production.
View Article and Find Full Text PDFNorepinephrine ameliorates sepsis-associated acute kidney injury through inhibiting damage of renal tubular epithelium induced by macrophage inflammatory response.
BMC Nephrol
August 2025
Department of Anaesthesiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
Background: Norepinephrine (NE) has been reported to not only regulate cardiovascular activity but also influence inflammatory responses. But its role in sepsis-associated acute kidney injury (SA-AKI) has yet to be elucidated.
Methods: SA-AKI mouse model was induced by intraperitoneally instillation of lipopolysaccharide.