Open AccessRussian multicenter observational clinical study “Register of respiratory therapy for patients with stroke (RETAS)”: a comparative analysis of the outcomes of stroke during mechanical ventilation
Author(s) -
В. И. Ершов,
Andrey Belkin,
I.B. Zabolotskikh,
В.И. Горбачев,
А.И. Грицан,
К.М. Лебединский,
Д Н Проценко,
И. Н. Лейдерман,
А. В. Щеголев,
С. С. Петриков,
А. А. Солодов,
А. А. Газенкампф,
A Chirkov,
V.V. Silkin,
S.K. Sukhotin,
S Yu Shamaev,
С. В. Горбачев,
Veronica Fisher,
I.V. Balaev,
R. R. Sadriev,
И. В. Мирошниченко,
A. V. Karpets,
A. V. Redyukov,
I.V. Sultanova,
K.D. Zybin,
A.A. Tikhomirova,
Т. И. Конарева,
V.V. Khodchenko,
R.Sh. Zaripov,
N. A. Bortsov,
A.A. Golubkina,
D.A. Gorbunov,
V.V. Tukhanov,
Sofya V. Ershova,
Alexey Meshcheryakov,
D.A. Kuzmichev,
K.S. Bolodurin,
N.V. Bragina,
Vera Stadler,
A.G. Katasonov
Publication year - 2020
Publication title -
vestnik intensivnoj terapii
Language(s) - English
Resource type - Journals
eISSN - 1818-474X
pISSN - 1726-9806
DOI - 10.21320/1818-474x-2020-4-28-41
Subject(s) - medicine , hyperventilation , stroke (engine) , hypoxemia , mechanical ventilation , observational study , intensive care medicine , ventilation (architecture) , emergency medicine , mortality rate , mechanical engineering , engineering
. Stroke has a high prevalence and mortality rate. Examining the impact of patient treatment on disease outcomes is particularly important for decision making in clinical practice. Obj'ectives. To analyze the treatment of patients with severe stroke requiring respiratory support, and identify predictors of death. Materials and methods. A multicenter observational clinical study “REspiratory Therapy for Acute Stroke” (RETAS) was conducted under the aegis of the “Federation of Anaesthesiologists and Reanimatologists” (FAR). The study involved 14 clinical centers and included 1289 stroke patients with respiratory support. Results. We found that initial hypoxemia in the 28-day period was associated with high mortality (in patients with 20 or more NIH scores) (p = 0.004). Risk factors for lethal outcome: hyperventilation used to relieve intracranial hypertension (in patients with 20 or more NIH scores) (p = 0.0336); volume-controlled ventilation (VC) versus pressure-controlled ventilation (PC) (in patients with 20 or more NIH scores) (p < 0.001); use of clinical methods for monitoring ICP in comparison with instrumental ones (p < 0.001). We found that the use of standard respiratory status monitoring scales (CPIS, LIS, etc.) was associated with a decrease in mortality (p < 0.001). Conclusions. We identified risk factors that increase mortality in patients with acute stroke with respiratory support: initial hypoxemia, lack of instrumental monitoring of ICP and monitoring of respiratory status according to standard scales, the use of hyperventilation, as well as volume-controlled ventilation.