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Anaesthesia, Critical Care & Pain... Aug 2020
Topics: Almitrine; Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Nitric Oxide; Oxygen Consumption; Pandemics; Pneumonia, Viral; Respiratory Distress Syndrome; Respiratory System Agents; Retrospective Studies; SARS-CoV-2; Vasoconstrictor Agents
PubMed: 32505755
DOI: 10.1016/j.accpm.2020.05.014 -
The Journal of Trauma and Acute Care... Aug 2020According to the Joint Theater Trauma Registry, 26% to 33% of war casualties develop acute respiratory distress syndrome (ARDS), with high mortality. Here, we aimed to... (Observational Study)
Observational Study
BACKGROUND
According to the Joint Theater Trauma Registry, 26% to 33% of war casualties develop acute respiratory distress syndrome (ARDS), with high mortality. Here, we aimed to describe ARDS incidence and severity among patients evacuated from war zones and admitted to French intensive care units (ICUs).
METHODS
We performed an observational retrospective multicentric review of all patients evacuated from war zones and admitted to French ICUs between 2003 and 2018. Our analysis included all medical and trauma patients developing ARDS according to the Berlin definition. We evaluated ARDS incidence, and determined ARDS severity from arterial blood gas analysis. Analyzed parameters included invasive ventilation duration, ARDS treatments, ICU stay length, and 30-day and 90-day mortalities.
RESULTS
Among 141 included patients (84% military; median age, 30 years), 57 (42%) developed ARDS. Acute respiratory distress syndrome was mild in 13 (22%) patients, moderate in 24 (42%) patients, and severe in 20 (36%) patients. Evacuation occurred in less than 26 hours for 32 war casualties, 17 non-war-related trauma patients, and 8 medical patients. Among severe trauma patients, median Injury Severity Score was 34, and Abbreviated Injury Scale thorax was 3. Upon French ICU admission, median partial pressure of oxygen in arterial blood/inspirated fraction of oxygen ratio was 241 [144-296]. Administered ARDS treatments included intubation (98%, n = 56), protective ventilation (87%, n = 49), neuromuscular blockade (76%, n = 43), prone position (16%, n = 9), inhaled nitric oxide (10%, n = 6), almitrine (7%, n = 7), and extracorporeal life support (4%, n = 2). Median duration of invasive ventilation was 13 days, ICU stay was 18 days, 30-day mortality was 14%, and 90-day mortality was 21%.
CONCLUSION
Acute respiratory distress syndrome was frequent and severe among French patients evacuated from war theaters. Improved treatment capacities are needed in the forward environment-for example, a specialized US team can provide extracorporeal life support for highly hypoxemic war casualties.
LEVEL OF EVIDENCE
Prognostic and epidemiological study, level III.
Topics: Adult; Blood Gas Analysis; Extracorporeal Membrane Oxygenation; Female; France; Humans; Incidence; Injury Severity Score; Intensive Care Units; Length of Stay; Male; Military Personnel; Patient Acuity; Respiratory Distress Syndrome; Retrospective Studies; War-Related Injuries
PubMed: 32102034
DOI: 10.1097/TA.0000000000002633 -
Anaesthesia, Critical Care & Pain... Aug 2020
Topics: Aged; Almitrine; Betacoronavirus; COVID-19; Case-Control Studies; Coronavirus Infections; Female; Humans; Hypoxia; Injections, Intravenous; Male; Middle Aged; Oxygen; Pandemics; Partial Pressure; Patient Positioning; Pneumonia, Viral; Prone Position; Respiratory Distress Syndrome; Respiratory System Agents; SARS-CoV-2
PubMed: 32505756
DOI: 10.1016/j.accpm.2020.05.013 -
Anaesthesia, Critical Care & Pain... Jun 2020
Topics: Almitrine; Betacoronavirus; COVID-19; Capillary Leak Syndrome; Coronavirus Infections; Humans; Hypoxia; Lung; Lung Compliance; Pandemics; Patient Positioning; Pneumonia, Viral; Positive-Pressure Respiration; Pulmonary Circulation; Pulmonary Edema; Respiratory Mechanics; SARS-CoV-2; Switzerland; Tomography, X-Ray Computed; Vasoconstriction; Vasoconstrictor Agents
PubMed: 32305591
DOI: 10.1016/j.accpm.2020.04.003 -
Anesthesia and Analgesia Aug 2019This single-center case series investigated the effect of almitrine infusion on PaO2/fraction of inspired oxygen (FIO2) in 25 patients on veno-venous extracorporeal... (Observational Study)
Observational Study
This single-center case series investigated the effect of almitrine infusion on PaO2/fraction of inspired oxygen (FIO2) in 25 patients on veno-venous extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. A positive trial was defined as an increase of PaO2/FIO2 ratio ≥20%. Thirty-two trials were performed. Twenty (62.5%, 95% confidence interval, 37.5%-75%) trials in 18 patients were positive, with a median PaO2/FIO2 ratio increase of 35% (25%-43%). A focal acute respiratory distress syndrome and inhaled nitric oxide therapy were more frequent in patients with a positive response to almitrine. We observed no complications of almitrine use.
Topics: Adult; Almitrine; Extracorporeal Membrane Oxygenation; Female; Humans; Infusions, Intravenous; Male; Middle Aged; Recovery of Function; Respiration; Respiratory Distress Syndrome; Respiratory System Agents; Retrospective Studies; Time Factors; Treatment Outcome
PubMed: 29337729
DOI: 10.1213/ANE.0000000000002786 -
Saudi Journal of Anaesthesia 2021
PubMed: 33824652
DOI: 10.4103/sja.SJA_782_20 -
Chest Nov 2020
Topics: Aged; Almitrine; Betacoronavirus; Blood Gas Analysis; COVID-19; Coronavirus Infections; Extracorporeal Membrane Oxygenation; Female; Humans; Hypoxia; Male; Middle Aged; Oxygen; Oxygen Inhalation Therapy; Pandemics; Partial Pressure; Patient Positioning; Pneumonia, Viral; Positive-Pressure Respiration; Prone Position; Respiration, Artificial; Respiratory Distress Syndrome; Respiratory System Agents; Retrospective Studies; SARS-CoV-2; Treatment Outcome
PubMed: 32512007
DOI: 10.1016/j.chest.2020.05.573 -
JACC. Case Reports Jul 2020Coronavirus disease-19 (COVID-19)-related severe acute respiratory distress syndrome can lead to acute cor pulmonale. We report a case of acute cor pulmonale secondary...
Coronavirus disease-19 (COVID-19)-related severe acute respiratory distress syndrome can lead to acute cor pulmonale. We report a case of acute cor pulmonale secondary to severe COVID-19 acute respiratory distress syndrome diagnosed with transesophageal echocardiography. Almitrine infusion allowed rapid enhancement of right ventricular function as well as improvement in oxygenation. ().
PubMed: 32835274
DOI: 10.1016/j.jaccas.2020.06.011