Abstract
On behalf of the ‘PRactice of VENTilation in Middle–income Countries’ (PRoVENT–iMiC) investigators:
Background: Protective ventilation consists of using a low tidal volume (VT) and sufficient positive end–expiratory pressure (PEEP). Limitations in resources may hamper implementation of protective ventilation.
Methods: PRoVENT–iMiC is an international multicentre 4–week study of ventilated adult patients in 54 ICUs from 10 Asian countries. The coprimary endpoints were VT and PEEP. Patients were stratified according to risk for (lung injury prediction score ≥ 4) and actual presence of ARDS; and females were compared to males.
Results: Of 1,315 patients, 68% [95%–CI, 66–71%] were at risk for ARDS, and 7% [95%–CI, 6–8%] actually had ARDS. In ARDS patients compared to non-ARDS patients, median VT was 7.0 [5.8–8.4] vs. 7.9 [6.8–9.2] ml/kg PBW (p<0.001) (Figure; cumulative distributions in panel A); median PEEP was 10 [5–12] vs. 5 [5–8] cm H2O (P<0.001) (panel B). In males compared to females, VT was 7.5 [6.5–8.4] vs. 8.6 [7.5–10.0] ml/kg PBW (p<0.001) (panel C), while PEEP was not different (P=0.078). Overall, 53% of patients received ventilation with a VT ≤ 8 ml/kg PBW; females received low VT less often when at risk for ARDS (40% vs. 77%) but not when having ARDS (panel D).
Conclusions: Protective ventilation is well practiced in this set of ICUs in Asian middle–income countries, also in ARDS patients. Alike in previous studies, females receive higher VT than males.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 3725.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020
