Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries

Toshikazu Abe; Fabiana Madotto; Tai Pham; Isao Nagata; Masatoshi Uchida; Nanako Tamiya; Kiyoyasu Kurahashi; Giacomo Bellani; John G. Laffey; Guy M. Francois; Francesca Rabboni; Sara Conti; Eddy Fan; Antonio Pesenti; Laurent Brochard; Andres Esteban; Luciano Gattinoni; Frank van Haren; Anders Larsson; Daniel F. McAuley; Marco Ranieri; Gordon Rubenfeld; B. Taylor Thompson; Hermann Wrigge; Arthur S. Slutsky; Fernando Rios; T. Sottiaux; P. Depuydt; Fredy S. Lora; Luciano Cesar x Azevedo; Guillermo Bugedo; Haibo Qiu; Marcos Gonzalez; Juan Silesky; Vladimir Cerny; Jonas Nielsen; Manuel Jibaja; Dimitrios Matamis; Jorge Luis Ranero; Pravin Amin; S. M. Hashemian; Kevin Clarkson; Asisclo Villagomez; Amine Ali Zeggwagh; Leo M. Heunks; Jon Henrik Laake; Jose Emmanuel Palo; Antero Do Vale Fernandes; Dorel Sandesc; Yaasen Arabi; Joan M. Lynch; null et al.

doi:10.1186/s13054-018-2126-6

Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries

Toshikazu Abe, Fabiana Madotto, Tai Pham, Isao Nagata, Masatoshi Uchida, Nanako Tamiya, Kiyoyasu Kurahashi, Giacomo Bellani, John G. Laffey, Guy M. Francois, Francesca Rabboni, Sara Conti, Eddy Fan, Antonio Pesenti, Laurent Brochard, Andres Esteban, Luciano Gattinoni, Frank van Haren, Anders Larsson, Daniel F. McAuleyMarco Ranieri, Gordon Rubenfeld, B. Taylor Thompson, Hermann Wrigge, Arthur S. Slutsky, Fernando Rios, T. Sottiaux, P. Depuydt, Fredy S. Lora, Luciano Cesar x Azevedo, Guillermo Bugedo, Haibo Qiu, Marcos Gonzalez, Juan Silesky, Vladimir Cerny, Jonas Nielsen, Manuel Jibaja, Dimitrios Matamis, Jorge Luis Ranero, Pravin Amin, S. M. Hashemian, Kevin Clarkson, Asisclo Villagomez, Amine Ali Zeggwagh, Leo M. Heunks, Jon Henrik Laake, Jose Emmanuel Palo, Antero Do Vale Fernandes, Dorel Sandesc, Yaasen Arabi, Joan M. Lynch, et al.

Western Sydney University

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: To better understand the epidemiology and patterns of tracheostomy practice for patients with acute respiratory distress syndrome (ARDS), we investigated the current usage of tracheostomy in patients with ARDS recruited into the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG-SAFE) study. Methods: This is a secondary analysis of LUNG-SAFE, an international, multicenter, prospective cohort study of patients receiving invasive or noninvasive ventilation in 50 countries spanning 5 continents. The study was carried out over 4 weeks consecutively in the winter of 2014, and 459 ICUs participated. We evaluated the clinical characteristics, management and outcomes of patients that received tracheostomy, in the cohort of patients that developed ARDS on day 1-2 of acute hypoxemic respiratory failure, and in a subsequent propensity-matched cohort. Results: Of the 2377 patients with ARDS that fulfilled the inclusion criteria, 309 (13.0%) underwent tracheostomy during their ICU stay. Patients from high-income European countries (n = 198/1263) more frequently underwent tracheostomy compared to patients from non-European high-income countries (n = 63/649) or patients from middle-income countries (n = 48/465). Only 86/309 (27.8%) underwent tracheostomy on or before day 7, while the median timing of tracheostomy was 14 (Q1-Q3, 7-21) days after onset of ARDS. In the subsample matched by propensity score, ICU and hospital stay were longer in patients with tracheostomy. While patients with tracheostomy had the highest survival probability, there was no difference in 60-day or 90-day mortality in either the patient subgroup that survived for at least 5 days in ICU, or in the propensity-matched subsample. Conclusions: Most patients that receive tracheostomy do so after the first week of critical illness. Tracheostomy may prolong patient survival but does not reduce 60-day or 90-day mortality.

Original language	English
Number of pages	16
Journal	Critical Care
Volume	22
Issue number	1
DOIs	https://doi.org/10.1186/s13054-018-2126-6
Publication status	Published - 2018

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© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Abe, T., Madotto, F., Pham, T., Nagata, I., Uchida, M., Tamiya, N., Kurahashi, K., Bellani, G., Laffey, J. G., Francois, G. M., Rabboni, F., Conti, S., Fan, E., Pesenti, A., Brochard, L., Esteban, A., Gattinoni, L., Haren, F. V., Larsson, A., ... et al. (2018). Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries. Critical Care, 22(1). https://doi.org/10.1186/s13054-018-2126-6

@article{c8af1028de1e47f783d2841f451c29b0,

title = "Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries",

abstract = "Background: To better understand the epidemiology and patterns of tracheostomy practice for patients with acute respiratory distress syndrome (ARDS), we investigated the current usage of tracheostomy in patients with ARDS recruited into the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG-SAFE) study. Methods: This is a secondary analysis of LUNG-SAFE, an international, multicenter, prospective cohort study of patients receiving invasive or noninvasive ventilation in 50 countries spanning 5 continents. The study was carried out over 4 weeks consecutively in the winter of 2014, and 459 ICUs participated. We evaluated the clinical characteristics, management and outcomes of patients that received tracheostomy, in the cohort of patients that developed ARDS on day 1-2 of acute hypoxemic respiratory failure, and in a subsequent propensity-matched cohort. Results: Of the 2377 patients with ARDS that fulfilled the inclusion criteria, 309 (13.0%) underwent tracheostomy during their ICU stay. Patients from high-income European countries (n = 198/1263) more frequently underwent tracheostomy compared to patients from non-European high-income countries (n = 63/649) or patients from middle-income countries (n = 48/465). Only 86/309 (27.8%) underwent tracheostomy on or before day 7, while the median timing of tracheostomy was 14 (Q1-Q3, 7-21) days after onset of ARDS. In the subsample matched by propensity score, ICU and hospital stay were longer in patients with tracheostomy. While patients with tracheostomy had the highest survival probability, there was no difference in 60-day or 90-day mortality in either the patient subgroup that survived for at least 5 days in ICU, or in the propensity-matched subsample. Conclusions: Most patients that receive tracheostomy do so after the first week of critical illness. Tracheostomy may prolong patient survival but does not reduce 60-day or 90-day mortality.",

author = "Toshikazu Abe and Fabiana Madotto and Tai Pham and Isao Nagata and Masatoshi Uchida and Nanako Tamiya and Kiyoyasu Kurahashi and Giacomo Bellani and Laffey, {John G.} and Francois, {Guy M.} and Francesca Rabboni and Sara Conti and Eddy Fan and Antonio Pesenti and Laurent Brochard and Andres Esteban and Luciano Gattinoni and Haren, {Frank van} and Anders Larsson and McAuley, {Daniel F.} and Marco Ranieri and Gordon Rubenfeld and Thompson, {B. Taylor} and Hermann Wrigge and Slutsky, {Arthur S.} and Fernando Rios and T. Sottiaux and P. Depuydt and Lora, {Fredy S.} and Azevedo, {Luciano Cesar x} and Guillermo Bugedo and Haibo Qiu and Marcos Gonzalez and Juan Silesky and Vladimir Cerny and Jonas Nielsen and Manuel Jibaja and Dimitrios Matamis and Ranero, {Jorge Luis} and Pravin Amin and Hashemian, {S. M.} and Kevin Clarkson and Asisclo Villagomez and Zeggwagh, {Amine Ali} and Heunks, {Leo M.} and Laake, {Jon Henrik} and Palo, {Jose Emmanuel} and {Do Vale Fernandes}, Antero and Dorel Sandesc and Yaasen Arabi and Lynch, {Joan M.} and {et al.}",

year = "2018",

doi = "10.1186/s13054-018-2126-6",

language = "English",

volume = "22",

journal = "Critical Care",

issn = "1466-609X",

publisher = "BioMed Central",

number = "1",

}

Abe, T, Madotto, F, Pham, T, Nagata, I, Uchida, M, Tamiya, N, Kurahashi, K, Bellani, G, Laffey, JG, Francois, GM, Rabboni, F, Conti, S, Fan, E, Pesenti, A, Brochard, L, Esteban, A, Gattinoni, L, Haren, FV, Larsson, A, McAuley, DF, Ranieri, M, Rubenfeld, G, Thompson, BT, Wrigge, H, Slutsky, AS, Rios, F, Sottiaux, T, Depuydt, P, Lora, FS, Azevedo, LCX, Bugedo, G, Qiu, H, Gonzalez, M, Silesky, J, Cerny, V, Nielsen, J, Jibaja, M, Matamis, D, Ranero, JL, Amin, P, Hashemian, SM, Clarkson, K, Villagomez, A, Zeggwagh, AA, Heunks, LM, Laake, JH, Palo, JE, Do Vale Fernandes, A, Sandesc, D, Arabi, Y, Lynch, JM & et al. 2018, 'Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries', Critical Care, vol. 22, no. 1. https://doi.org/10.1186/s13054-018-2126-6

TY - JOUR

T1 - Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries

AU - Abe, Toshikazu

AU - Madotto, Fabiana

AU - Pham, Tai

AU - Nagata, Isao

AU - Uchida, Masatoshi

AU - Tamiya, Nanako

AU - Kurahashi, Kiyoyasu

AU - Bellani, Giacomo

AU - Laffey, John G.

AU - Francois, Guy M.

AU - Rabboni, Francesca

AU - Conti, Sara

AU - Fan, Eddy

AU - Pesenti, Antonio

AU - Brochard, Laurent

AU - Esteban, Andres

AU - Gattinoni, Luciano

AU - Haren, Frank van

AU - Larsson, Anders

AU - McAuley, Daniel F.

AU - Ranieri, Marco

AU - Rubenfeld, Gordon

AU - Thompson, B. Taylor

AU - Wrigge, Hermann

AU - Slutsky, Arthur S.

AU - Rios, Fernando

AU - Sottiaux, T.

AU - Depuydt, P.

AU - Lora, Fredy S.

AU - Azevedo, Luciano Cesar x

AU - Bugedo, Guillermo

AU - Qiu, Haibo

AU - Gonzalez, Marcos

AU - Silesky, Juan

AU - Cerny, Vladimir

AU - Nielsen, Jonas

AU - Jibaja, Manuel

AU - Matamis, Dimitrios

AU - Ranero, Jorge Luis

AU - Amin, Pravin

AU - Hashemian, S. M.

AU - Clarkson, Kevin

AU - Villagomez, Asisclo

AU - Zeggwagh, Amine Ali

AU - Heunks, Leo M.

AU - Laake, Jon Henrik

AU - Palo, Jose Emmanuel

AU - Do Vale Fernandes, Antero

AU - Sandesc, Dorel

AU - Arabi, Yaasen

AU - Lynch, Joan M.

AU - et al., null

PY - 2018

Y1 - 2018

N2 - Background: To better understand the epidemiology and patterns of tracheostomy practice for patients with acute respiratory distress syndrome (ARDS), we investigated the current usage of tracheostomy in patients with ARDS recruited into the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG-SAFE) study. Methods: This is a secondary analysis of LUNG-SAFE, an international, multicenter, prospective cohort study of patients receiving invasive or noninvasive ventilation in 50 countries spanning 5 continents. The study was carried out over 4 weeks consecutively in the winter of 2014, and 459 ICUs participated. We evaluated the clinical characteristics, management and outcomes of patients that received tracheostomy, in the cohort of patients that developed ARDS on day 1-2 of acute hypoxemic respiratory failure, and in a subsequent propensity-matched cohort. Results: Of the 2377 patients with ARDS that fulfilled the inclusion criteria, 309 (13.0%) underwent tracheostomy during their ICU stay. Patients from high-income European countries (n = 198/1263) more frequently underwent tracheostomy compared to patients from non-European high-income countries (n = 63/649) or patients from middle-income countries (n = 48/465). Only 86/309 (27.8%) underwent tracheostomy on or before day 7, while the median timing of tracheostomy was 14 (Q1-Q3, 7-21) days after onset of ARDS. In the subsample matched by propensity score, ICU and hospital stay were longer in patients with tracheostomy. While patients with tracheostomy had the highest survival probability, there was no difference in 60-day or 90-day mortality in either the patient subgroup that survived for at least 5 days in ICU, or in the propensity-matched subsample. Conclusions: Most patients that receive tracheostomy do so after the first week of critical illness. Tracheostomy may prolong patient survival but does not reduce 60-day or 90-day mortality.

AB - Background: To better understand the epidemiology and patterns of tracheostomy practice for patients with acute respiratory distress syndrome (ARDS), we investigated the current usage of tracheostomy in patients with ARDS recruited into the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG-SAFE) study. Methods: This is a secondary analysis of LUNG-SAFE, an international, multicenter, prospective cohort study of patients receiving invasive or noninvasive ventilation in 50 countries spanning 5 continents. The study was carried out over 4 weeks consecutively in the winter of 2014, and 459 ICUs participated. We evaluated the clinical characteristics, management and outcomes of patients that received tracheostomy, in the cohort of patients that developed ARDS on day 1-2 of acute hypoxemic respiratory failure, and in a subsequent propensity-matched cohort. Results: Of the 2377 patients with ARDS that fulfilled the inclusion criteria, 309 (13.0%) underwent tracheostomy during their ICU stay. Patients from high-income European countries (n = 198/1263) more frequently underwent tracheostomy compared to patients from non-European high-income countries (n = 63/649) or patients from middle-income countries (n = 48/465). Only 86/309 (27.8%) underwent tracheostomy on or before day 7, while the median timing of tracheostomy was 14 (Q1-Q3, 7-21) days after onset of ARDS. In the subsample matched by propensity score, ICU and hospital stay were longer in patients with tracheostomy. While patients with tracheostomy had the highest survival probability, there was no difference in 60-day or 90-day mortality in either the patient subgroup that survived for at least 5 days in ICU, or in the propensity-matched subsample. Conclusions: Most patients that receive tracheostomy do so after the first week of critical illness. Tracheostomy may prolong patient survival but does not reduce 60-day or 90-day mortality.

UR - https://hdl.handle.net/1959.7/uws:67037

U2 - 10.1186/s13054-018-2126-6

DO - 10.1186/s13054-018-2126-6

M3 - Article

SN - 1466-609X

VL - 22

JO - Critical Care

JF - Critical Care

IS - 1

ER -

Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries

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