TY -的T1 -结果急性hypoxaemic respiratory failure: insights from the LUNG SAFE Study JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.03317-2020 VL - 57 IS - 6 SP - 2003317 AU - Pham, Tài AU - Pesenti, Antonio AU - Bellani, Giacomo AU - Rubenfeld, Gordon AU - Fan, Eddy AU - Bugedo, Guillermo AU - Lorente, José Angel AU - Fernandes, Antero do Vale AU - Van Haren, Frank AU - Bruhn, Alejandro AU - Rios, Fernando AU - Esteban, Andres AU - Gattinoni, Luciano AU - Larsson, Anders AU - McAuley, Daniel F. AU - Ranieri, Marco AU - Thompson, B. Taylor AU - Wrigge, Hermann AU - Brochard, Laurent J. AU - Laffey, John G. A2 - , Y1 - 2021/06/01 UR - //www.qdcxjkg.com/content/57/6/2003317.abstract N2 - Background Current incidence and outcome of patients with acute hypoxaemic respiratory failure requiring mechanical ventilation in the intensive care unit (ICU) are unknown, especially for patients not meeting criteria for acute respiratory distress syndrome (ARDS).Methods An international, multicentre, prospective cohort study of patients presenting with hypoxaemia early in the course of mechanical ventilation, conducted during four consecutive weeks in the winter of 2014 in 459 ICUs from 50 countries (LUNG SAFE). Patients were enrolled with arterial oxygen tension/inspiratory oxygen fraction ratio ≤300 mmHg, new pulmonary infiltrates and need for mechanical ventilation with a positive end-expiratory pressure of ≥5 cmH2O. ICU prevalence, causes of hypoxaemia, hospital survival and factors associated with hospital mortality were measured. Patients with unilateral versus bilateral opacities were compared.Findings 12 906 critically ill patients received mechanical ventilation and 34.9% with hypoxaemia and new infiltrates were enrolled, separated into ARDS (69.0%), unilateral infiltrate (22.7%) and congestive heart failure (CHF; 8.2%). The global hospital mortality was 38.6%. CHF patients had a mortality comparable to ARDS (44.1% versus 40.4%). Patients with unilateral-infiltrate had lower unadjusted mortality, but similar adjusted mortality compared to those with ARDS. The number of quadrants on chest imaging was associated with an increased risk of death. There was no difference in mortality comparing patients with unilateral-infiltrate and ARDS with only two quadrants involved.Interpretation More than one-third of patients receiving mechanical ventilation have hypoxaemia and new infiltrates with a hospital mortality of 38.6%. Survival is dependent on the degree of pulmonary involvement whether or not ARDS criteria are reached.Patients with hypoxaemic respiratory failure represent more than one-third of patients requiring mechanical ventilation and their mortality often exceeds 40%. Adjusting for severity, mortality is similar whether it is unilateral or bilateral (as in ARDS). https://bit.ly/2VshdWc ER -