Intensive Care Med (2004) 30:51–61 DOI 10.1007/s00134-003-2022-6
Christian Brun-Buisson Cosetta Minelli Guido Bertolini Luca Brazzi Jorge Pimentel Klaus Lewandowski Julian Bion Jacques-André Romand Jesús Villar Adalbjörn Thorsteinsson Pierre Damas Apostolos Armaganidis François Lemaire for the ALIVE Study Group
Received: 13 June 2003 Accepted: 10 September 2003 Published online: 16 October 2003 © Springer-Verlag 2003 Electronic Supplementary Material Supplementary material is available in the online version of this article at http://dx.doi.org/10.1007/s00134-003-2022-6
ORIGINAL
Epidemiology and outcome of acute lung injury in European intensive care units Results from the ALIVE study
J. Pimentel Intensive Care Unit, University Hospital, Coimbra, Portugal K. Lewandowski Klinik für Anaesthesiologie und operative Intensivmedizin, Charité Campus Virchow-Klinikum, Humboldt-Universität zu Berlin, Berlin, Germany J. Bion University Department of Anaesthesia and Intensive Care Medicine, N5 Queen Elizabeth Hospital, Birmingham, UK J.-A. Romand Surgical intensive care division, Hopitaux Universitaires de Genève, Geneva, Switzerland
C. Brun-Buisson (✉) · F. Lemaire Service de Réanimation Médicale, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) & Université Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil Cedex, France e-mail:
[email protected] Tel.: +33-1-49812391 Fax: +33-1-42079943 C. Minelli · G. Bertolini Centro di Coordinamento GiViTI, Istituto di Ricerche Farmacologiche “Mario Negri”, Ranica (Bergamo), Italy L. Brazzi Istituto di Anestesia e Rianimazione, Ospedale Maggiore IRCCS, Milan, Italy
J. Villar Research Institute, Hospital Universitario NS de Candelaria, Santa Cruz de Tenerife, Canary Islands, Spain A. Thorsteinsson Department of Anesthesia and Intensive Care Medicine, Landspitalinn University Hospital Hringbraut, Reykjavik, Iceland P. Damas Department of Anesthesia and Intensive Care, Centre Hospitalier Universitaire, Liège, Belgium A. Armaganidis Department of Critical Care, Medical School of Athens University, Athens, Greece
Abstract Objectives: To re-examine the epidemiology of acute lung injury (ALI) in European intensive care units (ICUs). Design and setting: A 2-month inception cohort study in 78 ICUs of 10 European countries. Patients: All patients admitted for more than 4 h were screened for ALI and followed up to 2 months. Measurements and main results: Acute lung injury occurred in 463 (7.1%) of 6,522 admissions and 16.1% of all mechanically ventilated patients; 65.4% cases occurred on ICU admission. Among 136 patients initially presenting with “mild ALI” (200< PaO2/FiO2 £300), 74 (55%) evolved to acute respiratory distress syndrome (ARDS) within 3 days. Sixty-two patients (13.4%) remained with mild ALI and 401 had ARDS. The crude ICU and hospital mortalities were 22.6% and 32.7% (p0), variables used for calculation of the Simplified Acute Physiology Score II (SAPS II) [24], underlying diseases including immuno-incompetence and its causes (steroids, chemotherapy, radiation, haematological malignancy, metastatic cancer, AIDS or other specific diseases) and the presence of chronic organ failure, using definitions from the Acute Physiology and Chronic Health Evaluation (APACHE II) score II [25]. In patients with ALI (either on admission—including in-patients staying in the ICU for
