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Lung-protective Ventilation in Patients with Brain Injury: A Multicenter Cross-sectional Study and Questionnaire Survey in China

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收录情况: ◇ SCIE ◇ 统计源期刊 ◇ CSCD-C ◇ 中华系列

单位: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Crit Care Med, Beijing 100050, Peoples R China [2]Zhejiang Univ, Dept Crit Care Med, Sch Med, Affiliated Hosp 2, Hangzhou 310009, Zhejiang, Peoples R China [3]Ningxia Med Univ, Dept Crit Care Med, Gen Hosp, Ningxia 750004, Peoples R China [4]Sichuan Univ, Dept Crit Care Med, West China Hosp, Chengdu 610041, Sichuan, Peoples R China [5]Capital Med Univ, Beijing Tiantan Hosp, Neurol Intens Care Unit, Beijing 100050, Peoples R China [6]Guangdong Gen Hosp, Dept Crit Care Med, Guangzhou 510000, Guangdong, Peoples R China [7]Fujian Prov Hosp, Surg Intens Care Unit, Fuzhou 350000, Fujian, Peoples R China [8]Xinjiang Med Univ, Dept Crit Care Med, Affiliated Hosp 1, Urumqi 830054, Xinjiang, Peoples R China [9]Bethune Int Peace Hosp, Dept Crit Care Med, Shijiazhuang 050000, Hebei, Peoples R China [10]Yuncheng Cent Hosp, Dept Crit Care Med, Yuncheng 044000, Shanxi, Peoples R China [11]Cangzhou Peoples Hosp, Dept Emergency & Crit Care Med, Cangzhou 061000, Hebei, Peoples R China [12]Capital Med Univ, Beijing Luhe Hosp, Dept Crit Care Med, Beijing 101100, Peoples R China [13]China Med Univ, Dept Crit Care Med, Hosp 1, Shenyang 110000, Liaoning, Peoples R China [14]Shanghai Changzheng Hosp, Dept Crit Care Med, Shanghai 200000, Peoples R China [15]Capital Med Univ, Beijing Shijitan Hosp, Dept Crit Care Med, Beijing 100038, Peoples R China [16]Capital Med Univ, Xuanwu Hosp, Dept Crit Care Med, Beijing 100053, Peoples R China [17]Miyun Cty Hosp, Dept Crit Care Med, Beijing 100038, Peoples R China [18]Peking Union Med Coll Hosp, Med Intens Care Unit, Beijing 101500, Peoples R China [19]Capital Med Univ, Beijing Friendship Hosp, Dept Crit Care Med, Beijing 100050, Peoples R China [20]Shanghai Fudan Univ, Dept Crit Care Med, Coll Med, Huashan Hosp, Shanghai 200040, Peoples R China [21]Changsha Cent Hosp, Intens Care Unit, Changsha 410018, Hunan, Peoples R China [22]Shanxi Prov Peoples Hosp, Dept Crit Care Med, Taiyuan 030012, Shanxi, Peoples R China [23]Fourth Mil Med Univ, Tangdu Hosp, Dept Crit Care Med, Xian 710000, Shaanxi, Peoples R China [24]Shanghai Jiao Tong Univ, Sch Med, Renji Hosp, Neurosurg Intens Care Unit, Shanghai 200240, Peoples R China [25]Henan Prov Peoples Hosp, Dept Crit Care Med, Zhengzhou 450000, Henan, Peoples R China [26]Gansu Prov Hosp, Dept Crit Care Med, Lanzhou 730000, Gansu, Peoples R China [27]Gen Hosp Shenyang Mil, Dept Crit Care Med, Shenyang 110000, Liaoning, Peoples R China [28]Inner Mongolia Peoples Hosp, Dept Crit Care Med, Hohhot 010017, Inner Mongolia, Peoples R China [29]Qinghai Prov Peoples Hosp, Dept Crit Care Med, Xining 810000, Qinghai, Peoples R China [30]Lanzhou Univ, Hosp 2, Dept Crit Care Med, Lanzhou 730030, Gansu, Peoples R China [31]Peking Univ, Hosp 1, Dept Crit Care Med, Beijing 100034, Peoples R China [32]China Japan Friendship Hosp, Dept Crit Care Med, Beijing 100029, Peoples R China [33]Jilin Univ, Norman Bethune Coll Med, Clin Hosp 1, Neurosurg Intens Care Unit, Changchun 130000, Jilin, Peoples R China [34]Jiangsu Prov Hosp, Dept Crit Care Med, Nanjing 210029, Jiangsu, Peoples R China [35]Shandong Univ, Qilu Hosp, Dept Crit Care Med, Jinan 250012, Shandong, Peoples R China [36]Jining 1 Peoples Hosp, Dept Crit Care Med, Jining 272011, Shandong, Peoples R China [37]Sichuan Prov Peoples Hosp, Dept Crit Care Med, Chengdu 610072, Sichuan, Peoples R China [38]Tianjin Huanhu Hosp, Dept Crit Care Med, Tianjin 300060, Peoples R China [39]Kunming Med Univ, Affiliated Hosp 1, Dept Emergency & Crit Care Med, Kunming 650032, Yunnan, Peoples R China [40]Capital Med Univ, Beijing Tongren Hosp, Dept Crit Care Med, Beijing 100041, Peoples R China [41]Beijing Pinggu Hosp, Dept Crit Care Med, Beijing 101200, Peoples R China [42]Hebei Gen Hosp, Dept Crit Care Med, Shijiazhuang 050051, Henan, Peoples R China [43]Zhengzhou Univ, Affiliated Hosp 1, Dept Crit Care Med, Zhengzhou 450052, Henan, Peoples R China [44]Liaocheng Peoples Hosp, Dept Crit Care Med, Liaocheng 252004, Shandong, Peoples R China [45]Shihezi Univ, Affiliated Hosp 1, Coll Med, Dept Crit Care Med, Shihezi 832008, Xinjiang, Peoples R China [46]Shandong Prov Hosp, Dept Crit Care Med, Jinan 250021, Shandong, Peoples R China [47]Zhejiang Univ, Affiliated Hosp 1, Neurosurg Intens Care Unit, Hangzhou 310003, Zhejiang, Peoples R China
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关键词: Brain Injury Epidemiology Lung-protective Ventilation Mechanical Ventilation

摘要:
Background: Over the years, the mechanical ventilation (MV) strategy has changed worldwide. The aim of the present study was to describe the ventilation practices, particularly lung-protective ventilation (LPV), among brain-injured patients in China. Methods: This study was a multicenter, 1-day, cross-sectional study in 47 Intensive Care Units (ICUs) across China. Mechanically ventilated patients (18 years and older) with brain injury in a participating ICU during the time of the study, including traumatic brain injury, stroke, postoperation with intracranial tumor, hypoxic-ischemic encephalopathy, intracranial infection, and idiopathic epilepsy, were enrolled. Demographic data, primary diagnoses, indications for MV, MV modes and settings, and prognoses on the 60th day were collected. Multivariable logistic analysis was used to assess factors that might affect the use of LPV. Results: A total of 104 patients were enrolled in the present study, 87 (83.7%) of whom were identified with severe brain injury based on a Glasgow Coma Scale <= 8 points. Synchronized intermittent mandatory ventilation (SIMV) was the most frequent ventilator mode, accounting for 46.2% of the entire cohort. The median tidal volume was set to 8.0 ml/kg (interquartile range [ IQR], 7.0-8.9 ml/kg) of the predicted body weight; 50 (48.10%) patients received LPV. The median positive end-expiratory pressure (PEEP) was set to 5 cmH(2)O (IQR, 5-6 cmH(2)O). No PEEP values were higher than 10 cmH(2)O. Compared with partially mandatory ventilation, supportive and spontaneous ventilation practices were associated with LPV. There were no significant differences in mortality and MV duration between patients subjected to LPV and those were not. Conclusions: Among brain-injured patients in China, SIMV was the most frequent ventilation mode. Nearly one-half of the brain-injured patients received LPV. Patients under supportive and spontaneous ventilation were more likely to receive LPV.

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出版当年[2015]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 医学:内科
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出版当年[2014]版:
Q3 MEDICINE, GENERAL & INTERNAL
最新[2023]版:
Q1 MEDICINE, GENERAL & INTERNAL

影响因子: 最新[2023版] 最新五年平均[2021-2025] 出版当年[2014版] 出版当年五年平均[2010-2014] 出版前一年[2013版] 出版后一年[2015版]

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第一作者单位: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Crit Care Med, Beijing 100050, Peoples R China
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