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Qadir N, Bartz RR, Cooter ML, et al. Variation in Early Management Practices in Moderate-to-Severe ARDS in the United States: The Severe ARDS: Generating Evidence Study. Chest. 2021;160(4):1304-1315doi: 10.1016/j.chest.2021.05.047.
Qadir, N., Bartz, R. R., Cooter, M. L., Hough, C. L., Lanspa, M. J., Banner-Goodspeed, V. M., Chen, J. T., Giovanni, S., Gomaa, D., Sjoding, M. W., Hajizadeh, N., Komisarow, J., Duggal, A., Khanna, A. K., Kashyap, R., Khan, A., Chang, S. Y., Tonna, J. E., Anderson, H. L., Liebler, J. M., Mosier, J. M., Morris, P. E., Genthon, A., Louh, I. K., Tidswell, M., Stephens, R. S., Esper, A. M., Dries, D. J., Martinez, A., Schreyer, K. E., Bender, W., Tiwari, A., Guru, P. K., Hanna, S., Gong, M. N., Park, P. K. (2021). Variation in Early Management Practices in Moderate-to-Severe ARDS in the United States: The Severe ARDS: Generating Evidence Study. Chest, 160(4), 1304-1315. https://doi.org/10.1016/j.chest.2021.05.047
Qadir, Nida, et al. "Variation in Early Management Practices in Moderate-to-Severe ARDS in the United States: The Severe ARDS: Generating Evidence Study." Chest vol. 160,4 (2021): 1304-1315. doi: https://doi.org/10.1016/j.chest.2021.05.047
Qadir N, Bartz RR, Cooter ML, Hough CL, Lanspa MJ, Banner-Goodspeed VM, Chen JT, Giovanni S, Gomaa D, Sjoding MW, Hajizadeh N, Komisarow J, Duggal A, Khanna AK, Kashyap R, Khan A, Chang SY, Tonna JE, Anderson HL, Liebler JM, Mosier JM, Morris PE, Genthon A, Louh IK, Tidswell M, Stephens RS, Esper AM, Dries DJ, Martinez A, Schreyer KE, Bender W, Tiwari A, Guru PK, Hanna S, Gong MN, Park PK. Variation in Early Management Practices in Moderate-to-Severe ARDS in the United States: The Severe ARDS: Generating Evidence Study. Chest. 2021 Oct;160(4):1304-1315. doi: 10.1016/j.chest.2021.05.047. Epub 2021 Jun 04. PMID: 34089739; PMCID: PMC8176896.
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Chest. 2021 Oct;160(4):1304-1315. doi: 10.1016/j.chest.2021.05.047. Epub 2021 Jun 04.

Variation in Early Management Practices in Moderate-to-Severe ARDS in the United States: The Severe ARDS: Generating Evidence Study.

Chest

Nida Qadir, Raquel R Bartz, Mary L Cooter, Catherine L Hough, Michael J Lanspa, Valerie M Banner-Goodspeed, Jen-Ting Chen, Shewit Giovanni, Dina Gomaa, Michael W Sjoding, Negin Hajizadeh, Jordan Komisarow, Abhijit Duggal, Ashish K Khanna, Rahul Kashyap, Akram Khan, Steven Y Chang, Joseph E Tonna, Harry L Anderson, Janice M Liebler, Jarrod M Mosier, Peter E Morris, Alissa Genthon, Irene K Louh, Mark Tidswell, R Scott Stephens, Annette M Esper, David J Dries, Anthony Martinez, Kraftin E Schreyer, William Bender, Anupama Tiwari, Pramod K Guru, Sinan Hanna, Michelle N Gong, Pauline K Park,

Affiliations

  1. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA.
  2. Division of Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC.
  3. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health and Science University, Portland, OR.
  4. Division of Pulmonary Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT; Intermountain Medical Center, Murray, UT.
  5. Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
  6. Division of Critical Care Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY.
  7. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA.
  8. Department of Surgery, University of Cincinnati Medical Center, Cincinnati, OH.
  9. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
  10. Division of Pulmonary Critical Care and Sleep Medicine, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY.
  11. Department of Emergency Medicine, Temple University Hospital, Philadelphia, PA; Department of Neurosurgery, Duke University Medical Center, Durham, NC.
  12. Department of Critical Care Medicine, Cleveland Clinic, Cleveland, OH.
  13. Section of Critical Care Medicine, Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC; Outcomes Research Consortium, Cleveland, OH.
  14. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
  15. Divisions of Cardiothoracic Surgery and Emergency Medicine, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT.
  16. Department of Surgery, St. Joseph Mercy Hospital, Ann Arbor, MI.
  17. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
  18. Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, AZ.
  19. Division of Pulmonary, Critical Care & Sleep Medicine, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY.
  20. Department of Critical Care Medicine, Mayo Clinic, Scottsdale, AZ.
  21. Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY; New York-Presbyterian Hospital.
  22. Division of Pulmonary and Critical Care Medicine Baystate Medical Center and University of Massachusetts Medical School, Springfield, MA.
  23. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  24. Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA.
  25. Department of Surgery, Regions Medical Center, St. Paul, MN.
  26. Division of Critical Care, St. Agnes Hospital, Baltimore, MD.
  27. Department of Emergency Medicine, Temple University Hospital, Philadelphia, PA.
  28. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Albany Medical College, Albany, NY.
  29. Division of Critical Care Medicine, Department of Medicine, Mayo Clinic, Jacksonville, FL.
  30. Division of Acute Care Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI.
  31. Division of Acute Care Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI. Electronic address: [email protected].

PMID: 34089739 PMCID: PMC8176896 DOI: 10.1016/j.chest.2021.05.047

Abstract

BACKGROUND: Although specific interventions previously demonstrated benefit in patients with ARDS, use of these interventions is inconsistent, and patient mortality remains high. The impact of variability in center management practices on ARDS mortality rates remains unknown.

RESEARCH QUESTION: What is the impact of treatment variability on mortality in patients with moderate to severe ARDS in the United States?

STUDY DESIGN AND METHODS: We conducted a multicenter, observational cohort study of mechanically ventilated adults with ARDS and Pao

RESULTS: A total of 2,466 patients were enrolled. Median baseline Pao

INTERPRETATION: Substantial center-to-center variability exists in ARDS management, suggesting that further opportunities for improving ARDS outcomes exist. Early adherence to LPV was associated with lower center mortality and may be a surrogate for overall quality of care processes. Future collaboration is needed to identify additional treatment-level factors influencing center-level outcomes.

TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT03021824; URL: www.clinicaltrials.gov.

Copyright © 2021. Published by Elsevier Inc.

Keywords: ARDS; corticosteroids; extracorporeal membrane oxygenation; mechanical ventilation; neuromuscular blockade; prone positioning

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