Table 1.
Variables | NC-ARDS (n = 82) | C-ARDS (n = 90) | p value |
---|---|---|---|
Age, median [IQR] | 63 [57–71] | 59 [53–69] | 0.09 |
Male gender | 54 (66%) | 74 (82%) | 0.01 |
Medical history | |||
Mc Cabe and Jackson classification | < 0.001 | ||
No underlying disease | 47 (57%) | 76 (84%) | |
Ultimately fatal | 24 (29%) | 12 (13%) | |
Rapidly fatal disease | 11 (14%) | 2 (2%) | |
Charlson comorbidity index | 2 [1–3] | 1 [0–2] | < 0.001 |
Diabetes mellitus | 23 (28%) | 39 (43%) | 0.037 |
Congestive heart failure (NYHA 3–4) | 6 (7%) | 7 (8%) | 0.91 |
Supraventricular arrhythmia | 12 (15%) | 8 (9%) | 0.24 |
Hypertension | 36 (44%) | 59 (66%) | 0.004 |
COPD | 10 (12%) | 9 (10%) | 0.64 |
Chronic renal failure | 11 (13%) | 14 (16%) | 0.69 |
Dialysis | 3 (4%) | 2 (2%) | 0.67 |
Stroke | 5 (6%) | 4 (4%) | 0.74 |
Liver cirrhosis (Child C) | 1 (1%) | 0 | 0.48 |
Current smoking | 22 (27%) | 25 (28%) | 0.89 |
Immunosuppression conditions | 40 (49%) | 16 (18%) | < 0.001 |
Solid cancer | 4 (5%) | 5 (6%) | 0.99 |
Blood cancer | 17 (21%) | 1 (1%) | < 0.001 |
Organ transplant | 9 (11%) | 5 (6%) | 0.19 |
HIV infection | 4 (5%) | 3 (3%) | 0.71 |
Sickle cell disease | 2 (2%) | 3 (3%) | 0.99 |
Others | 5 (6%) | 2 (2%) | 0.26 |
Clinical characteristics upon ICU admission | |||
SAPS II | 49 [37–67] | 36 [27–45] | < 0.001 |
Baseline SOFA—median [IQR] | 9 [5–12] | 7 [4–8] | < 0.001 |
PaO2/FiO2 ratio (mmHg) median [IQR] | 162 [101–210] | 120 [92–163] | 0.005 |
ARDS classification (Berlin definition) | 0.018 | ||
Mild | 24 (29%) | 11 (12%) | |
Moderate | 39 (48%) | 49 (54%) | |
Severe | 19 (23%) | 30 (33%) | |
Norepinephrine, n (%) | 43 (52%) | 42 (47%) | 0.45 |
Serum creatinine (µmol/L) | 108 [72–195] | 83 [6–128] | 0.004 |
White blood cell count (× 109/L) | 7.5 [0–15] | 8.2 [5–12] | 0.49 |
Lymphocyte count (× 109/L) | 0.6 [0.3–1.1] | 0.8 [0.5–1.2] | 0.03 |
Lymphocyte count (× 109/L) in non-immunocompromised patients | 0.8 [0.4–1.2] | 0.8 [0.5–1.2] | 0.62 |
Documented bacterial coinfection | 38 (48%) | 14 (16%) | < 0.001 |
Treatment during the first 24 h | |||
Antibiotics | 81 (99%) | 90 (100%) | 0.48 |
Antiviral treatment | 58 (71%) | 69 (76%) | 0.39 |
Corticosteroids (any dose)* | 30/81 (37%) | 12/87 (14%) | 0.001 |
Corticosteroids (low dose)*# | 29/81 (36%) | 10/87 (12%) | < 0.001 |
Corticosteroids (high dose)* | 1/81 (1%) | 2/87 (2%) | 0.60 |
ARDS treatment during ICU stay | |||
Corticosteroids (any dose)* | 37/81 (46%) | 35 /87 (40%) | 0.48 |
Corticosteroids (low dose)*# | 33/81 (41%) | 25/87 (29%) | 0.10 |
Corticosteroids (high dose)* | 3/81 (4%) | 10/87 (12%) | 0.06 |
Prone position | 34 (42%) | 75 (83%) | < 0.001 |
Neuromuscular blockade | 53 (65%) | 83 (92%) | < 0.001 |
Inhaled nitric oxide | 10 (12%) | 31 (34%) | 0.01 |
Extra-corporeal membrane oxygenation | 9 (11%) | 23 (26%) | 0.014 |
ICU-acquired infections | |||
First VAP | 36 (44%) | 58 (64%) | 0.007 |
Number of days of mechanical ventilation before first VAP | 7 [5–9] | 8 [5–12] | 0.89 |
Number of VAP during ICU | 0 [0–1] | 1 [0–2] | < 0.001 |
Recurrent VAP | 10 (12%) | 22 (25%) | 0.36 |
MDR VAP during ICU stay | 9 (11%) | 21 (23%) | 0.03 |
ESBL PE VAP | 9 (11%) | 18 (20%) | 0.10 |
MRSA VAP | 0 | 1 (1%) | 0.99 |
CRE VAP | 0 | 3 (3%) | 0.095 |
Sampling frequency (number/day of MV) | 0.23 [0.14–0.37] | 0.32 [0.20–0.38] | 0.03 |
Organ support and outcome during ICU stay | |||
Subglottic secretion drainage | 26 (32%) | 42 (47%) | 0.045 |
Renal replacement therapy during ICU stay | 28 (34%) | 30 (33%) | 0.91 |
Norepinephrine, n (%) | 66 (81%) | 67 (74%) | 0.34 |
ICU length of stay among survivors, days | 15 [10–20] | 30 [19–45] | < 0.001 |
Successful mechanical ventilation weaning | 54 (66%) | 46 (51%) | 0.05 |
Death at day 28 | 25 (31%) | 36 (40%) | 0.19 |
Death in the ICU | 27 (33%) | 37 (41%) | 0.27 |
Still in ICU or in weaning center (until May 28th, 2020) | 0 | 8 (9%) | 0.007 |
VAP ventilator-associated pneumonia, COPD chronic obstructive pulmonary disease, HIV human immunodeficiency virus, SAPS II Simplified Acute Physiology Score II, SOFA sequential organ failure assessment, ICU intensive care unit, MDR multi-drug resistant, ESBL-PE extended-spectrum β-lactamase-producing Enterobacteriaceae, MRSA methicillin-resistant Staphylococcus aureus, CRE carbapenem-resistant Enterobacteriaceae, MV mechanical ventilation
*Four missing values because two patients received dexamethasone or placebo in a randomized controlled trial
#Less than 1 mg/kg of prednisone or equivalent