Short women with severe sepsis-related acute lung injury receive lung protective ventilation less frequently: an observational cohort studyReport as inadecuate




Short women with severe sepsis-related acute lung injury receive lung protective ventilation less frequently: an observational cohort study - Download this document for free, or read online. Document in PDF available to download.

Journal Title:

Critical Care Nursing Quarterly

Volume:

Volume 15, Number 6

Publisher:

Lippincott, Williams and Wilkins: No Hybrid Open Access | 2011-01-01, Pages R262-R262

Type of Work:

Article | Final Publisher PDF

Abstract: Introduction: Lung protective ventilation LPV has been shown to improve survival and the duration of mechanical ventilation in acute lung injury ALI patients. Mortality of ALI may vary by gender, which could result from treatment variability. Whether gender is associated with the use of LPV is not known. Methods: 421 severe sepsis-related ALI subjects in the Consortium to Evaluate Lung Edema Genetics from seven teaching hospitals between 2002 and 2008 were included in our study. We evaluated patients' tidal volume, plateau pressure and arterial pH to determine whether patients received LPV during the first two days after developing ALI. The odds ratio of receiving LPV was estimated by a logistic regression model with robust and cluster options. Results: Women had similar characteristics as men with the exception of lower height and higher illness severity, as measured by Acute Physiology and Chronic Health Evaluation APACHE II score. 225 53% of the subjects received LPV during the first two days after ALI onset; Women received LPV less frequently than men 46% versus 59%, p < 0.001. However, after adjustment for height and severity of illness APACHE II, there was no difference in exposure to LPV between men and women p = 0.262. Conclusions: Short people are less likely to receive LPV, which seems to explain the tendency of clinicians to adhere to LPV less strictly in women. Strategies to standardize application of LPV, independent of differences in height and severity of illness, are necessary.

Subjects: Health Sciences, General - Health Sciences, Immunology - Keywords: Science and Technology - Life Sciences and Biomedicine - Critical Care Medicine - General and Internal Medicine - CRITICAL CARE MEDICINE - RESPIRATORY-DISTRESS-SYNDROME - CRITICALLY-ILL PATIENTS - MECHANICAL VENTILATION - MYOCARDIAL-INFARCTION - CONSENSUS CONFERENCE - TRAUMA-HEMORRHAGE - INTENSIVE-CARE - CLINICAL-TRIAL - UNITED-STATES - GENDER -



Author: SeungHye Han, Gregory Martin, James P. Maloney, Carl Shanholtz, Kathleen C. Barnes, Stacey Murray, Jonathan Sevransky,

Source: https://open.library.emory.edu/



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