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The prognostic value of cardiac dysfunction assessed by bedside echocardiography in critically ill patients with COPD requiring mechanical ventilation: a study protocol.

ABSTRACT: Chronic obstructive lung disease is not only a major cause of morbidity and mortality, but is also the major reason for intensive care unit (ICU) admission. Cardiac function is often impaired in this disease, but its association with clinical outcome has not been fully established.This is a prospective observational study conducted in a 47-bed mixed ICU of a tertiary academic teaching hospital. The study will be performed from January 2014 to December 2015. All patients meeting the diagnostic criteria of acute exacerbation of chronic obstructive pulmonary disease and admitted to the ICU are potentially eligible for the present study. The relevant demographics and laboratory measurements have been obtained. Transthoracic echocardiography was performed immediately after ICU admission by experienced intensivists. The Cox proportional hazard regression model has been fitted by using a stepwise forward selection and backward elimination technique. If linear assumption is not satisfied, the linear spline function will be used.The study protocol was approved by the ethics committee of Jinhua municipal central hospital. The results will be published in a peer-reviewed journal and shared with the worldwide medical community.The study protocol is registered at ClinicalTrials.gov (NCT02099279).

SUBMITTER: Zhang Z

PROVIDER: S-EPMC4179574 | biostudies-literature | 2014 Sep

REPOSITORIES: biostudies-literature

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The prognostic value of cardiac dysfunction assessed by bedside echocardiography in critically ill patients with COPD requiring mechanical ventilation: a study protocol.

Zhang Zhongheng Z Chen Lin L Chen Kun K Ni Hongying H

BMJ open 20140925 9

<h4>Introduction</h4>Chronic obstructive lung disease is not only a major cause of morbidity and mortality, but is also the major reason for intensive care unit (ICU) admission. Cardiac function is often impaired in this disease, but its association with clinical outcome has not been fully established.<h4>Methods and analysis</h4>This is a prospective observational study conducted in a 47-bed mixed ICU of a tertiary academic teaching hospital. The study will be performed from January 2014 to Dec ...[more]

PMID: 25256186

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Project description:Studying interhospital transfer of critically ill patients with coronavirus disease 2019 pneumonia in the spring 2020 surge may help inform future pandemic management.ObjectivesTo compare outcomes for mechanically ventilated patients with coronavirus disease 2019 transferred to a tertiary referral center with increased surge capacity with patients admitted from the emergency department.Design setting participantsObservational cohort study of single center urban academic medical center ICUs. All patients admitted and discharged with coronavirus disease 2019 pneumonia who received invasive ventilation between March 17, 2020, and October 14, 2020.Main outcome and measuresDemographic and clinical variables were obtained from the electronic medical record. Patients were classified as emergency department admits or interhospital transfers. Regression models tested the association between transfer status and survival, adjusting for demographics and presentation severity.ResultsIn total, 298 patients with coronavirus disease 2019 pneumonia were admitted to the ICU and received mechanical ventilation. Of these, 117 were transferred from another facility and 181 were admitted through the emergency department. Patients were primarily male (64%) and Black (38%) or Hispanic (45%). Transfer patients differed from emergency department admits in having English as a preferred language (71% vs 56%; p = 0.008) and younger age (median 57 vs 61 yr; p < 0.001). There were no differences in race/ethnicity or primary payor. Transfers were more likely to receive extracorporeal membrane oxygenation (12% vs 3%; p = 0.004). Overall, 50 (43%) transferred patients and 78 (43%) emergency department admits died prior to discharge. There was no significant difference in hospital mortality or days from intubation to discharge between the two groups.Conclusions and relevanceIn a single-center retrospective cohort, no significant differences in hospital mortality or length of stay between interhospital transfers and emergency department admits were found. While more study is needed, this suggests that interhospital transfer of critically ill patients with coronavirus disease 2019 can be done safely and effectively.

Dataset Information

The prognostic value of cardiac dysfunction assessed by bedside echocardiography in critically ill patients with COPD requiring mechanical ventilation: a study protocol.

Publications

The prognostic value of cardiac dysfunction assessed by bedside echocardiography in critically ill patients with COPD requiring mechanical ventilation: a study protocol.

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