Acute Lung Injury, Mechanical Ventilation, Respiratory Failure
Conditions
Keywords
Respiratory failure, Mechanical ventilation, Acute lung injury
Brief summary
Despite its life-saving potential, the mechanical ventilator has great potential to do harm. Despite years of research, the mortality in acute lung injury (ALI) remains very high. Treatment options after ALI onset are very limited, therefore prevention may be the best option. Unfortunately, the emergency department has not been studied with respect to mechanical ventilation practices, and its contribution to ALI is unknown. The investigators hypothesize that mechanical ventilation is frequently used in the ED and for a variety of reasons, and that ED mechanical ventilation has an effect on long term outcomes.
Interventions
OTHERFor inclusion in the study, patients will have to require mechanical ventilation either via an endotracheal tube or tracheostomy tube.
Mechanical ventilation via an endotracheal tube or tracheostomy tube
Sponsors
University of Iowa
Christiana Care Health Services
University of Cincinnati
Washington University School of Medicine
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Ventilation either via an endotracheal tube or tracheostomy
Exclusion criteria
* Non-invasive positive pressure ventilation; * Death in the immediate post-intubation phase of care; * Chronic ventilator-dependence, either at home or extended care facility.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To Further Characterize ED Mechanical Ventilation | 1 month | In a prospective cross-sectional study design, we will enroll all patients receiving mechanical ventilation in the ED over a one-month time frame. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The Incidence of ARDS in Mechanically Ventilated Emergency Department Patients, and Risk Factors Associated With Progression to ARDS | 1 month | Development of ARDS after admission to the hospital |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Entire Cohort Characteristics of mechanically ventilated ED patients | 219 |
| Total | 219 |
Baseline characteristics
| Characteristic | Entire Cohort |
|---|---|
| Age, Customized age | 55.6 years STANDARD_DEVIATION 19.9 |
| Race/Ethnicity, Customized black | 59 participants |
| Race/Ethnicity, Customized other | 8 participants |
| Race/Ethnicity, Customized white | 152 participants |
| Sex: Female, Male Female | 91 Participants |
| Sex: Female, Male Male | 128 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 72 / 219 |
| other Total, other adverse events | 0 / 219 |
| serious Total, serious adverse events | 0 / 219 |
Outcome results
Primary
To Further Characterize ED Mechanical Ventilation
In a prospective cross-sectional study design, we will enroll all patients receiving mechanical ventilation in the ED over a one-month time frame.
Time frame: 1 month
Population: Tidal volume used for the entire cohort
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Entire Cohort | To Further Characterize ED Mechanical Ventilation | 500 mL |
Secondary
The Incidence of ARDS in Mechanically Ventilated Emergency Department Patients, and Risk Factors Associated With Progression to ARDS
Development of ARDS after admission to the hospital
Time frame: 1 month
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Entire Cohort | The Incidence of ARDS in Mechanically Ventilated Emergency Department Patients, and Risk Factors Associated With Progression to ARDS | 30 participants |
p-value: <0.05Regression, Logistic