Lung protective mechanical ventilation and two year survival in patients with acute lung injury: prospective cohort study
Why is this work in the frame?
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
No Canadian affiliation. An affiliation-only frame — the usual design — would never have seen this work. It is one of the works that make the case for inverting the frame.
Machine scores (provisional)
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
- Teacher spread
- 0.296 · how far apart the two teachers sit on this one work
- Validation status
score_only:v0-immature-baseline· verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it
Abstract
OBJECTIVE: To evaluate the association of volume limited and pressure limited (lung protective) mechanical ventilation with two year survival in patients with acute lung injury. DESIGN: Prospective cohort study. SETTING: 13 intensive care units at four hospitals in Baltimore, Maryland, USA. PARTICIPANTS: 485 consecutive mechanically ventilated patients with acute lung injury. MAIN OUTCOME MEASURE: Two year survival after onset of acute lung injury. RESULTS: 485 patients contributed data for 6240 eligible ventilator settings, as measured twice daily (median of eight eligible ventilator settings per patient; 41% of which adhered to lung protective ventilation). Of these patients, 311 (64%) died within two years. After adjusting for the total duration of ventilation and other relevant covariates, each additional ventilator setting adherent to lung protective ventilation was associated with a 3% decrease in the risk of mortality over two years (hazard ratio 0.97, 95% confidence interval 0.95 to 0.99, P=0.002). Compared with no adherence, the estimated absolute risk reduction in two year mortality for a prototypical patient with 50% adherence to lung protective ventilation was 4.0% (0.8% to 7.2%, P=0.012) and with 100% adherence was 7.8% (1.6% to 14.0%, P=0.011). CONCLUSIONS: Lung protective mechanical ventilation was associated with a substantial long term survival benefit for patients with acute lung injury. Greater use of lung protective ventilation in routine clinical practice could reduce long term mortality in patients with acute lung injury. TRIAL REGISTRATION: Clinicaltrials.gov NCT00300248.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
The record
- Venue
- BMJ
- Topic
- Respiratory Support and Mechanisms
- Field
- Medicine
- Canadian institutions
- —
- Funders
- National Institute of General Medical SciencesNational Heart, Lung, and Blood InstituteCanadian Institutes of Health ResearchNational Institutes of Health
- Keywords
- MedicineMechanical ventilationHazard ratioProspective cohort studyLungVentilation (architecture)Confidence intervalCohortCohort studyInternal medicineAnesthesia
- Has abstract in OpenAlex
- yes