Dataset Information

Association between the time-varying arterial carbon dioxide pressure and 28-day mortality in mechanically ventilated patients with acute respiratory distress syndrome.

ABSTRACT:

Background

Recent studies have shown an association between baseline arterial carbon dioxide pressure (PaCO₂) and outcomes in patients with acute respiratory distress syndrome (ARDS). However, PaCO₂ probably varies throughout the disease, and few studies have assessed the effect of longitudinal PaCO₂ on prognosis. We thus aimed to investigate the association between time-varying PaCO₂ and 28-day mortality in mechanically ventilated ARDS patients.

Methods

In this retrospective study, we included all adult (≥ 18 years) patients diagnosed with ARDS who received mechanical ventilation for at least 24 h at a tertiary teaching hospital between January 2014 and March 2021. Patients were excluded if they received extracorporeal membrane oxygenation (ECMO). Demographic data, respiratory variables, and daily PaCO₂ were extracted. The primary outcome was 28-day mortality. Time-varying Cox models were used to estimate the association between longitudinal PaCO₂ measurements and 28-day mortality.

Results

A total of 709 patients were eligible for inclusion in the final cohort, with an average age of 65 years, of whom 70.7% were male, and the overall 28-day mortality was 35.5%. After adjustment for baseline confounders, including age and severity of disease, a significant increase in the hazard of death was found to be associated with both time-varying PaCO₂ (HR 1.07, 95% CI 1.03-1.11, p<0.001) and the time-varying coefficient of variation for PaCO₂ (HR 1.24 per 10% increase, 95% CI 1.10-1.40, p<0.001) during the first five days of invasive mechanical ventilation. The cumulative proportion of exposure to normal PaCO₂ (HR 0.72 per 10% increase, 95% CI 0.58-0.89, p = 0.002) was associated with 28-day mortality.

Conclusion

PaCO₂ should be closely monitored in mechanically ventilated ARDS patients. The association between PaCO₂ and 28-day mortality persisted over time. Increased cumulative exposure to normal PaCO₂ was associated with a decreased risk of death.

SUBMITTER: Zhang R

PROVIDER: S-EPMC10113995 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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Publications

Association between the time-varying arterial carbon dioxide pressure and 28-day mortality in mechanically ventilated patients with acute respiratory distress syndrome.

Zhang Rui R Chen Hui H Teng Ran R Li Zuxian Z Yang Yi Y Qiu Haibo H Liu Ling L

BMC pulmonary medicine 20230419 1

<h4>Background</h4>Recent studies have shown an association between baseline arterial carbon dioxide pressure (PaCO<sub>2</sub>) and outcomes in patients with acute respiratory distress syndrome (ARDS). However, PaCO<sub>2</sub> probably varies throughout the disease, and few studies have assessed the effect of longitudinal PaCO<sub>2</sub> on prognosis. We thus aimed to investigate the association between time-varying PaCO<sub>2</sub> and 28-day mortality in mechanically ventilated ARDS patient ...[more]

PMID: 37076846

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Dataset Information

Association between the time-varying arterial carbon dioxide pressure and 28-day mortality in mechanically ventilated patients with acute respiratory distress syndrome.

Background

Methods

Results

Conclusion

Publications

Association between the time-varying arterial carbon dioxide pressure and 28-day mortality in mechanically ventilated patients with acute respiratory distress syndrome.

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