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Dam TA, de Grooth HJ, Klausch T, et al. Some Patients Are More Equal Than Others: Variation in Ventilator Settings for Coronavirus Disease 2019 Acute Respiratory Distress Syndrome. Crit Care Explor. 2021;3(10):e0555doi: 10.1097/CCE.0000000000000555.
Dam, T. A., de Grooth, H. J., Klausch, T., Fleuren, L. M., de Bruin, D. P., Entjes, R., Rettig, T. C. D., Dongelmans, D. A., Boelens, A. D., Rigter, S., Hendriks, S. H. A., de Jong, R., Kamps, M. J. A., Peters, M., Karakus, A., Gommers, D., Ramnarain, D., Wils, E. J., Achterberg, S., Nowitzky, R., van den Tempel, W., de Jager, C. P. C., Nooteboom, F. G. C. A., Oostdijk, E., Koetsier, P., Cornet, A. D., Reidinga, A. C., de Ruijter, W., Bosman, R. J., Frenzel, T., Urlings-Strop, L. C., de Jong, P., Smit, E. G. M., Cremer, O. L., Mehagnoul-Schipper, D. J., Faber, H. J., Lens, J., Brunnekreef, G. B., Festen-Spanjer, B., Dormans, T., Dijkstra, A., Simons, B., Rijkeboer, A. A., Arbous, S., Aries, M., Beukema, M., Pretorius, D., van Raalte, R., van Tellingen, M., Gritters van den Oever, N. C., Lalisang, R. C. A., Tonutti, M., Girbes, A. R. J., Hoogendoorn, M., Thoral, P. J., & Elbers, P. W. G. (2021). Some Patients Are More Equal Than Others: Variation in Ventilator Settings for Coronavirus Disease 2019 Acute Respiratory Distress Syndrome. Critical care explorations, 3(10), e0555. https://doi.org/10.1097/CCE.0000000000000555
Dam, Tariq A, et al. "Some Patients Are More Equal Than Others: Variation in Ventilator Settings for Coronavirus Disease 2019 Acute Respiratory Distress Syndrome." Critical care explorations vol. 3,10 (2021): e0555. doi: https://doi.org/10.1097/CCE.0000000000000555
Dam TA, de Grooth HJ, Klausch T, Fleuren LM, de Bruin DP, Entjes R, Rettig TCD, Dongelmans DA, Boelens AD, Rigter S, Hendriks SHA, de Jong R, Kamps MJA, Peters M, Karakus A, Gommers D, Ramnarain D, Wils EJ, Achterberg S, Nowitzky R, van den Tempel W, de Jager CPC, Nooteboom FGCA, Oostdijk E, Koetsier P, Cornet AD, Reidinga AC, de Ruijter W, Bosman RJ, Frenzel T, Urlings-Strop LC, de Jong P, Smit EGM, Cremer OL, Mehagnoul-Schipper DJ, Faber HJ, Lens J, Brunnekreef GB, Festen-Spanjer B, Dormans T, Dijkstra A, Simons B, Rijkeboer AA, Arbous S, Aries M, Beukema M, Pretorius D, van Raalte R, van Tellingen M, Gritters van den Oever NC, Lalisang RCA, Tonutti M, Girbes ARJ, Hoogendoorn M, Thoral PJ, Elbers PWG. Some Patients Are More Equal Than Others: Variation in Ventilator Settings for Coronavirus Disease 2019 Acute Respiratory Distress Syndrome. Crit Care Explor. 2021 Oct 14;3(10):e0555. doi: 10.1097/CCE.0000000000000555. eCollection 2021 Oct. PMID: 34671747; PMCID: PMC8522869.
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Crit Care Explor. 2021 Oct 14;3(10):e0555. doi: 10.1097/CCE.0000000000000555. eCollection 2021 Oct.

Some Patients Are More Equal Than Others: Variation in Ventilator Settings for Coronavirus Disease 2019 Acute Respiratory Distress Syndrome.

Critical care explorations

Tariq A Dam, Harm-Jan de Grooth, Thomas Klausch, Lucas M Fleuren, Daan P de Bruin, Robert Entjes, Thijs C D Rettig, Dave A Dongelmans, Age D Boelens, Sander Rigter, Stefaan H A Hendriks, Remko de Jong, Marlijn J A Kamps, Marco Peters, A Karakus, Diederik Gommers, Dharmanand Ramnarain, Evert-Jan Wils, Sefanja Achterberg, Ralph Nowitzky, Walter van den Tempel, Cornelis P C de Jager, Fleur G C A Nooteboom, Evelien Oostdijk, Peter Koetsier, Alexander D Cornet, Auke C Reidinga, Wouter de Ruijter, Rob J Bosman, Tim Frenzel, Louise C Urlings-Strop, Paul de Jong, Ellen G M Smit, Olaf L Cremer, D Jannet Mehagnoul-Schipper, Harald J Faber, Judith Lens, Gert B Brunnekreef, Barbara Festen-Spanjer, Tom Dormans, Annemieke Dijkstra, Bram Simons, A A Rijkeboer, Sesmu Arbous, Marcel Aries, Menno Beukema, Daniël Pretorius, Rutger van Raalte, Martijn van Tellingen, Niels C Gritters van den Oever, Robbert C A Lalisang, Michele Tonutti, Armand R J Girbes, Mark Hoogendoorn, Patrick J Thoral, Paul W G Elbers

Affiliations

  1. Department of Intensive Care Medicine, Laboratory for Critical Care Computational Intelligence, Amsterdam Medical Data Science, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
  2. Department of Clinical Epidemiology, Laboratory for Critical Care Computational Intelligence, Amsterdam Medical Data Science, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
  3. Pacmed, Amsterdam, The Netherlands.
  4. Department of Intensive Care, Admiraal De Ruyter Ziekenhuis, Goes, The Netherlands.
  5. Department of Intensive Care, Amphia Ziekenhuis, Breda, The Netherlands.
  6. Department of Intensive Care Medicine, Laboratory for Critical Care Computational Intelligence, Amsterdam Medical Data Science, Amsterdam UMC, Amsterdam, The Netherlands.
  7. Department of Anesthesiology, Antonius Ziekenhuis Sneek, Sneek, The Netherlands.
  8. Department of Anesthesiology and Intensive Care, St. Antonius Hospital, Nieuwegein, The Netherlands.
  9. Department of Intensive Care, Albert Schweitzerziekenhuis, Dordrecht, The Netherlands.
  10. Department of Intensive Care, Bovenij Ziekenhuis, Amsterdam, The Netherlands.
  11. Department of Intensive Care, Catharina Ziekenhuis Eindhoven, Eindhoven, The Netherlands.
  12. Department of Intensive Care, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands.
  13. Department of Intensive Care, Diakonessenhuis Hospital, Utrecht, The Netherlands.
  14. Department of Intensive Care, Erasmus Medical Center, Rotterdam, The Netherlands.
  15. Department of Intensive Care, ETZ Tilburg, Tilburg, The Netherlands.
  16. Department of Intensive Care, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands.
  17. Department of Intensive Care, Haaglanden Medisch Centrum, Den Haag, The Netherlands.
  18. Department of Intensive Care, HagaZiekenhuis, Den Haag, The Netherlands.
  19. Department of Intensive Care, Ikazia Ziekenhuis Rotterdam, Rotterdam, The Netherlands.
  20. Department of Intensive Care, Jeroen Bosch Ziekenhuis, Den Bosch, The Netherlands.
  21. Department of Intensive Care, Laurentius Ziekenhuis, Roermond, The Netherlands.
  22. Department of Intensive Care, Maasstad Ziekenhuis Rotterdam, Rotterdam, The Netherlands.
  23. Department of Intensive Care, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands.
  24. Department of Intensive Care, Medisch Spectrum Twente, Enschede, The Netherlands.
  25. Department of Intensive Care, SEH, BWC, Martiniziekenhuis, Groningen, The Netherlands.
  26. Department of Intensive Care Medicine, Northwest Clinics, Alkmaar, The Netherlands.
  27. Department of Intensive Care, OLVG, Amsterdam, The Netherlands.
  28. Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
  29. Department of Intensive Care, Reinier de Graaf Gasthuis, Delft, The Netherlands.
  30. Department of Anesthesia and Intensive Care, Slingeland Ziekenhuis, Doetinchem, The Netherlands.
  31. Department of Intensive Care, Spaarne Gasthuis, Haarlem en Hoofddorp, The Netherlands.
  32. Department of Intensive Care, UMC Utrecht, Utrecht, The Netherlands.
  33. Department of Intensive Care, VieCuri Medisch Centrum, Venlo, The Netherlands.
  34. Department of Intensive Care, WZA, Assen, The Netherlands.
  35. Department of Intensive Care, IJsselland Ziekenhuis, Capelle aan den IJssel, The Netherlands.
  36. Department of Intensive Care, Ziekenhuisgroep Twente, Almelo, The Netherlands.
  37. Department of Intensive Care, Ziekenhuis Gelderse Vallei, Ede, The Netherlands.
  38. Department of Intensive Care, Zuyderland MC, Heerlen, The Netherlands.
  39. Department of Intensive Care Medicine, Het Van Weel-Bethesda Ziekenhuis, Dirksland, The Netherlands.
  40. Department of Intensive Care, Bravis Ziekenhuis, Bergen op Zoom en Roosendaal, The Netherlands.
  41. Department of Intensive Care, Flevoziekenhuis, Almere, The Netherlands.
  42. Department of Intensive Care, LUMC, Leiden, The Netherlands.
  43. Department of Intensive Care, MUMC+, University Maastricht, Maastricht, The Netherlands.
  44. Department of Intensive Care, Streekziekenhuis Koningin Beatrix, Winterswijk, The Netherlands.
  45. Department of Intensive Care Medicine, Hospital St Jansdal, Harderwijk, The Netherlands.
  46. Department of Intensive Care, Tergooi Hospital, Hilversum, The Netherlands.
  47. Department of Intensive Care Medicine, afdeling Intensive Care, ziekenhuis Tjongerschans, Heerenveen, The Netherlands.
  48. Department of Intensive Care, Treant Zorggroep, Emmen, The Netherlands.
  49. Department of Computer Science, Quantitative Data Analytics Group, Department of Computer Science, Faculty of Science, VU University, Amsterdam, The Netherlands.

PMID: 34671747 PMCID: PMC8522869 DOI: 10.1097/CCE.0000000000000555

Abstract

OBJECTIVES: As coronavirus disease 2019 is a novel disease, treatment strategies continue to be debated. This provides the intensive care community with a unique opportunity as the population of coronavirus disease 2019 patients requiring invasive mechanical ventilation is relatively homogeneous compared with other ICU populations. We hypothesize that the novelty of coronavirus disease 2019 and the uncertainty over its similarity with noncoronavirus disease 2019 acute respiratory distress syndrome resulted in substantial practice variation between hospitals during the first and second waves of coronavirus disease 2019 patients.

DESIGN: Multicenter retrospective cohort study.

SETTING: Twenty-five hospitals in the Netherlands from February 2020 to July 2020, and 14 hospitals from August 2020 to December 2020.

PATIENTS: One thousand two hundred ninety-four critically ill intubated adult ICU patients with coronavirus disease 2019 were selected from the Dutch Data Warehouse. Patients intubated for less than 24 hours, transferred patients, and patients still admitted at the time of data extraction were excluded.

MEASUREMENTS AND MAIN RESULTS: We aimed to estimate between-ICU practice variation in selected ventilation parameters (positive end-expiratory pressure, Fio

CONCLUSIONS: This is the first study to clearly demonstrate significant practice variation between ICUs related to mechanical ventilation parameters that are under direct control by intensivists. Their effect on clinical outcomes for both coronavirus disease 2019 and other critically ill mechanically ventilated patients could have widespread implications for the practice of intensive care medicine and should be investigated further by causal inference models and clinical trials.

Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.

Keywords: acute respiratory distress syndrome; clinical practice variation; coronavirus disease 2019; mechanical ventilation

Conflict of interest statement

The authors have disclosed that they do not have any potential conflicts of interest.

References

  1. Crit Care Med. 2021 Mar 1;49(3):e219-e234 - PubMed
  2. JAMA. 2016 Feb 23;315(8):788-800 - PubMed
  3. Intensive Care Med. 2021 Apr;47(4):478-481 - PubMed
  4. Lancet. 2007 Oct 20;370(9596):1453-7 - PubMed
  5. Am J Bioeth. 2021 Jan;21(1):4-13 - PubMed
  6. Chest. 2021 Oct;160(4):1304-1315 - PubMed
  7. Intensive Care Med. 2021 Mar;47(3):361-362 - PubMed
  8. Intensive Care Med. 2020 Dec;46(12):2157-2167 - PubMed

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