Predictors of Survival in Critically Ill Patients With Acute Respiratory Distress Syndrome (ARDS)

Discrete variables are presented as number of percentage and were analysed with Chi square test for nonparametric samples. Continuous variables are presented as median and 25/75 percentiles and were analysed with Mann–Whitney-U-Test for nonparametric samples. * p < 0,05
APACHE II Acute Physiology And Chronic Health Evaluation II, d days, ICU intensive care unit, LOS length of stay, SAPS II Simplified Acute Physiology Score II, SOFA Sequential Organ Failure Assessment, TISS Therapeutic Intervention Scoring System, CCI Charlson comorbidity index, F _i O ₂ inspiratory fraction of oxygen, iNO inhalative nitric oxide, PBW predicted body weight, P _a CO ₂ arterial partial pressure of carbon dioxide, P _a O ₂ arterial partial pressure of oxygen, PEEP positive end-expiratory pressure, P _mean mean airway pressure, P _peak peak airway pressure, V _t tidal volume, ECLA extracorporeal lung assist, ECMO extracorporeal membrane oxygenation, ELAD extracorporeal lung assist devices. Complete data on hospital stay in referring institutions was available for 309 patients

Parameters considered in the multivariate regression model using backwards selection that had significant impact in univariate analyses: age, BMI, Charlson comorbidity index (CCI), ICU admission scores (APACHE II, SOFA, TISS28), ELAD (yes/no) as well as clinical variables that were assessed on day 3 (SOFA score), C_rs Compliance of respiratory system by C_rs = V_T/(P_plat - P_mean) pH day 3, V_t/PBW, P_peak, Prone position, categories of Berlin definition and AECC definition, P_aO₂/F_iO₂. Data of 341 patients were considered. * p < 0,05. All parameters of the final regression model are presented, regardless of their significance
BMI Body Mass Index, CCI Charlson comorbidity index, CI confidence interval, ELAD extracorporeal lung assist devices (including extracorporeal lung assist (ECLA) and extracorporeal membrane oxygenation (ECMO), F _i O ₂ inspiratory fraction of oxygen, HR Hazard Ratio, OI oxygenation index, PBW predicted body weight, P _peak peak airway pressure, TISS Therapeutic Intervention Scoring System

Discrete variables are presented as median and percentage and were analysed with Chi square test for nonparametric samples. Continuous variables are presented as median and 25/75 percentiles and were analysed with Mann–Whitney-U-Test for nonparametric samples. * p < 0,05
d days, h hours, ICU intensive care unit, n number, LOS length of stay, OI oxygenation index calculated as median for each day by OI = (F_iO₂/P_aO₂[mmHg]) × P_mean × 100). The cut-off value was derived from Youden – Index corresponding to the area under the ROC curve for OI on day 3 for all patients

Authors and Disclosures

Felix Balzer¹, Mario Menk¹, Jannis Ziegler², Christian Pille¹, Klaus-Dieter Wernecke³, Claudia Spies¹, Maren Schmidt⁴, Steffen Weber-Carstens^1*† and Maria Deja^1,2*†

¹Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum/Campus Charité Mitte, Augustenburger Platz 1, D-13353 Berlin, Germany. ²Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany. ³SOSTANA GmbH, Wildensteiner Str. 27, 10318 Berlin, Germany. ⁴Department of Anaesthesiology and Intensive Care Medicine, Werner Forßmann Krankenhaus, 16225 Eberswalde, Germany.

*Correspondence
steffen.weber-carstens@charite.de; maria.deja@charite.de

^†Equal contributors

Authors' contributions
FB performed data collection and statistical analysis; drafted parts of the manuscript; shared responsibility for design, coordination, and finalization of the manuscript; contributed to interpretation of the data, and had full access to the data. MM drafted the introduction and discussion section. JZ performed data collection and contributed to the draft of all parts of the manuscript. KW contributed to the design of the study regarding statistical analysis, interpretation of the data, was involved in drafting the methods section, and critically reviewed the manuscript. MM, CP, CS, and MS contributed to the draft of the discussion section and critically revised the manuscript for intellectual content. SW and MD outlined the study design; contributed to draft all sections of the manuscript, interpretation of data, shared responsibility for design, coordination, and finalization of the manuscript; and had full access to the data. All authors read and approved the manuscript.

Competing interests
The authors declare that they have no competing interests regarding the submitted work. Claudia Spies received funding unrelated to this study from Abbott, Aspect, Baxter, BBraun, Essex Pharma, Fresenius Kabi, GSK, and Wyeth. Steffen Weber-Carstens received honoraria for lectures from Dräger, Maquet, and Novalung.