The goal of this observational study is to estimate the prevalence of the use of protective ventilation with low tidal volume ventilation in the transition of spontaneous ventilation modes in patients with hypoxemic acute respiratory failure in ICUs in Latin America and its association with patient outcomes. The main questions it aims to answer are: * what is the prevalence of the use of low tidal volume ventilation (VT \<8 mL/kg of predicted body weight) in the first 24 hours of spontaneous ventilation modes in patients with hypoxemic acute respiratory failure? * Is there an association between the rate of adherence to low tidal volume ventilation in spontaneous ventilation modes and the ability to stay off ventilatory support and mortality? Participants are patients with acute respiratory failure under mechanical ventilation. Investigators will collect data on the ventilatory parameters of participants * 24 hours before they begin to be ventilated with spontaneous modes of ventilation * during the first 24 hours of spontaneous ventilation Investigators will collect several patient-centered clinical outcomes at 28 days after study inclusion, including ventilator-free days and mortality
Investigators will conduct a cohort study in Intensive Care Units (ICUs) across Latin America, aiming to include 422 patients with Hypoxemic Acute Respiratory Failure (ARF) and under invasive mechanical ventilation. The goal of this observational study is to estimate the prevalence of the use of protective ventilation with low tidal volume ventilation in the transition of spontaneous ventilation modes in patients with hypoxemic acute respiratory failure in ICUs in Latin America The primary objectives are to determine the prevalence of low tidal volume ventilation (VT \< 8 mL/kg of predicted body weight) during the initial 24 hours of spontaneous ventilatory modes in patients diagnosed with hypoxemic ARF and its association with clinically important patient outcomes. Investigators are interested in assessing the rate of adherence to low tidal volume ventilation, defined as maintaining VT \< 8 mL/kg of predicted body weight during the first 24 hours of ventilation in spontaneous mode.They are also interested in measuring the number of days that patients are alive and not receiving ventilatory support and survival at 28 days. Investigators will also measure the proportion of patients experiencing significant asynchrony during the transition to spontaneous mechanical ventilation, who revert to sedation and controlled mechanical ventilation within the first 24 hours or at any point during mechanical ventilation.
Study Type
OBSERVATIONAL
Enrollment
422
any mode of mechanical ventilation classified as spontaneous or proportional, mainly pressure support ventilation, but also CPAP, APRV, NAVA, PAV+
Sanatorio Juncal SA
Buenos Aires, Argentina
RECRUITINGHospital Municipal Boliviano Holandés, Universidad Mayor de San Andrés
La Paz, Bolivia
NOT_YET_RECRUITINGHospital das Clínicas -HCFMUSP
São Paulo, São Paulo, Brazil
RECRUITINGPontificia Universidad Catolica de Chile
Santiago, Chile
RECRUITINGClinica Universidad de la Sabana
Chía, Colombia
RECRUITINGHospital Eugenio Espejo
Quito, Ecuador
RECRUITINGHospital Civil Fray Antonio Alcalde
Guadalajara, Mexico
RECRUITINGHospital San Roque
Asunción, Paraguay
RECRUITINGHospital Rebagliati
Lima, Peru
RECRUITINGHospital Espanol
Montevideo, Uruguay
RECRUITINGLow tidal volume
Low tidal volume, defined as less or equal to 8 mLs per Kg of predicted body weight
Time frame: 24 hours
Ventilator- free days
number of days alive and not receiving invasive mechanical ventilation after transition to spontaneous ventilation
Time frame: 28 days
Hospital mortality
mortality in the hospital
Time frame: 28 days
Rate of patient-ventilator asynchrony
presence of patient asynchrony 24h after transition to a spontaneous mode of mechanical ventilation
Time frame: 24 hours
Number of participants that return to controlled mechanical ventilation in the first 24 hours
return to controlled mechanical ventilation in the first 24 hours after transition to spontaneous ventilation
Time frame: 24 hours
Number of participants that return to sedation in the first 24 hours
return to sedation in the first 24 hours after transition to spontaneous ventilation
Time frame: 24 hours
Number of participants that return to controlled mechanical ventilation after transition to spontaneous ventilation
return to controlled mechanical ventilation any time after transition to spontaneous ventilation
Time frame: 28 days
Number of participants that return to sedation after transition to spontaneous ventilation
return to sedation any time after transition to spontaneous ventilation
Time frame: 28 days
Number of participants with PEEP and FIO2 compatible with the ARDSnet PEEP/FIO2 table
adherence to ARDSnet low PEEP/FIO2 table after transition to spontaneous ventilation
Time frame: 24 hours
Number of participants who were extubated
Extubation and discontinuation of mechanical ventilation after the transition to spontaneous mode
Time frame: 28 days
Rate of reintubation
Reintubation after transition to spontaneous mode and extubation
Time frame: 28 days
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