Pub Date : 2021-06-01DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2812
Marissa Su, Ehab Daoud
Background: Adaptive support ventilation (ASV) is an intelligent mode of mechanical ventilation protocol which uses a closed-loop control between breaths. The algorithm states that for a given level of alveolar ventilation, there is a particular respiratory rate and tidal volume which achieve a lower work of breathing. The mode allows the clinician to set a desired minute ventilation percentage (MV%) while the ventilator automatically selects the target ventilatory pattern base on these inputs and feedback from the ventilator monitoring system. The goal is to minimize the work of breathing and reduce complications by allowing the ventilator to adjust the breath delivery taking into account the patient’s respiratory mechanics (Resistance, and Compliance). In this study we examine the effect of patients’ respiratory effort on target tidal volume (VT) and Minute Ventilation (V̇e) during ASV using breathing simulator. Methods: A bench study was performed by using the ASL 5000 breathing simulator to compare the target ventilator to actual VT and V̇e value in simulated patients with various level of respiratory effort during ASV on the Hamilton G5 ventilator. The clinical scenario involves simulated adult male with IBW 70kg and normal lung mechanics: respiratory compliance of 70 mL/cm H2O, and airway resistance of 9 cm H2O/L/s. Simulated patients were subjected to five different level of muscle pressure (Pmus): 0 (Passive), -5, -10, -15, -25 (Active) cm H2O at a set respiratory rate of 10 (below targeted VT) set at three different levels of minute ventilation goals: 100%, 200%, and 300%, with a PEEP of 5 cm H2O. Fifty breaths were analyzed in every experiment. Means and standard deviations (SD) of variables were calculated. One way analysis of variants was done to compare the values. Pearson correlation coefficient test was used to calculate the correlation between the respiratory effort and the VT, V̇e, and peak inspiratory pressure (PIP). Results: The targeted VT and V̇e were not significant in the passive patient when no effort was present, however were significantly higher in the active states at all levels of Pmus on the 100%, 200% and the 300 MV%. The VT and V̇e increase correlated with the muscle effort in the 100 and 200 MV% but did not in the 300%. Conclusions: Higher inspiratory efforts resulted in significantly higher VT and V̇e than targeted ones. Estimating patients’ effort is important during setting ASV. Keywords: Mechanical ventilation, ASV, InteliVent, Pmus, tidal volume, percent minute ventilation
{"title":"Effect of Respiratory Effort on Target Minute Ventilation During Adaptive Support Ventilation","authors":"Marissa Su, Ehab Daoud","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2812","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2812","url":null,"abstract":"Background: Adaptive support ventilation (ASV) is an intelligent mode of mechanical ventilation protocol which uses a closed-loop control between breaths. The algorithm states that for a given level of alveolar ventilation, there is a particular respiratory rate and tidal volume which achieve a lower work of breathing. The mode allows the clinician to set a desired minute ventilation percentage (MV%) while the ventilator automatically selects the target ventilatory pattern base on these inputs and feedback from the ventilator monitoring system. The goal is to minimize the work of breathing and reduce complications by allowing the ventilator to adjust the breath delivery taking into account the patient’s respiratory mechanics (Resistance, and Compliance). In this study we examine the effect of patients’ respiratory effort on target tidal volume (VT) and Minute Ventilation (V̇e) during ASV using breathing simulator. Methods: A bench study was performed by using the ASL 5000 breathing simulator to compare the target ventilator to actual VT and V̇e value in simulated patients with various level of respiratory effort during ASV on the Hamilton G5 ventilator. The clinical scenario involves simulated adult male with IBW 70kg and normal lung mechanics: respiratory compliance of 70 mL/cm H2O, and airway resistance of 9 cm H2O/L/s. Simulated patients were subjected to five different level of muscle pressure (Pmus): 0 (Passive), -5, -10, -15, -25 (Active) cm H2O at a set respiratory rate of 10 (below targeted VT) set at three different levels of minute ventilation goals: 100%, 200%, and 300%, with a PEEP of 5 cm H2O. Fifty breaths were analyzed in every experiment. Means and standard deviations (SD) of variables were calculated. One way analysis of variants was done to compare the values. Pearson correlation coefficient test was used to calculate the correlation between the respiratory effort and the VT, V̇e, and peak inspiratory pressure (PIP). Results: The targeted VT and V̇e were not significant in the passive patient when no effort was present, however were significantly higher in the active states at all levels of Pmus on the 100%, 200% and the 300 MV%. The VT and V̇e increase correlated with the muscle effort in the 100 and 200 MV% but did not in the 300%. Conclusions: Higher inspiratory efforts resulted in significantly higher VT and V̇e than targeted ones. Estimating patients’ effort is important during setting ASV. Keywords: Mechanical ventilation, ASV, InteliVent, Pmus, tidal volume, percent minute ventilation","PeriodicalId":255004,"journal":{"name":"TP55. TP055 MECHANICAL VENTILATION, ICU MANAGEMENT, AND CV","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121705030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2818
G. Jaffe, M. Flynn, N. Qadir
{"title":"Volume Resuscitation Practices in End Stage Renal Disease Patients with Septic Shock","authors":"G. Jaffe, M. Flynn, N. Qadir","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2818","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2818","url":null,"abstract":"","PeriodicalId":255004,"journal":{"name":"TP55. TP055 MECHANICAL VENTILATION, ICU MANAGEMENT, AND CV","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129017355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2808
H. Ahmad, H. Chaudhry, D. Oh, U.A. Mahmood, A. Gohar
{"title":"BPAP vs AVAPS for Hypercapnic Respiratory Failure: A Retrospective Analysis","authors":"H. Ahmad, H. Chaudhry, D. Oh, U.A. Mahmood, A. Gohar","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2808","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2808","url":null,"abstract":"","PeriodicalId":255004,"journal":{"name":"TP55. TP055 MECHANICAL VENTILATION, ICU MANAGEMENT, AND CV","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127009771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2831
E. Sonntag, K. Dover, J. Banks, T. Bice, J. Cadigan, A. Davis
{"title":"Prevalence, Degree, and Drivers of Resident Burnout During MICU Rotations","authors":"E. Sonntag, K. Dover, J. Banks, T. Bice, J. Cadigan, A. Davis","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2831","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2831","url":null,"abstract":"","PeriodicalId":255004,"journal":{"name":"TP55. TP055 MECHANICAL VENTILATION, ICU MANAGEMENT, AND CV","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114874209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2827
B. Ademi, T. Smith, T. Rusher, T. Pham, A. Gillet, M. Moore, M. Brown, M. Flanagan, M. Mahendran, J. Mai, J. Oh, Y. Zu, J. Denson
{"title":"Resident Transitions of Care and Antimicrobial Use Among Patients in the Intensive Care Unit","authors":"B. Ademi, T. Smith, T. Rusher, T. Pham, A. Gillet, M. Moore, M. Brown, M. Flanagan, M. Mahendran, J. Mai, J. Oh, Y. Zu, J. Denson","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2827","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2827","url":null,"abstract":"","PeriodicalId":255004,"journal":{"name":"TP55. TP055 MECHANICAL VENTILATION, ICU MANAGEMENT, AND CV","volume":"7 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128926090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2850
M. Biehl, K. Sarin, E. Bishop, J. Veith, M. Holztrager, K. Bash, J. O’Brien, H. Khouli
Introduction: Advancements in critical care medicine have led to increase in Intensive Care Unit (ICU) survival. ICU survivors often experience cognitive, mental and physical impairments as part of a condition called Post- Intensive Care Syndrome (PICS). While there are several ICU follow-up programs, there is variability in their structure and approach. We describe the creation and implementation of a Post-ICU Recovery Clinic (PIRC). Methods: A retrospective observational study was conducted and included all patients seen in a PIRC of a quaternary health system from December 2019 to September 2020. PIRC visit variables included scores on several validated questionnaires screening for mental health and cognitive disorders, 6-minute walk test, pulmonary function test, change in occupational and driving status, and referrals made during PIRC visit. Statistics reported reflect exclusion of the missing data points. Results: The criteria utilized for patient selection was circulatory shock, acute respiratory distress syndrome (ARDS), mechanical ventilation >7 days, ICU admission >7 days, delirium, cardiac arrest and COVID-19 with ICU stay >2 days. A total of 63 patients were seen in PIRC, 41% of those were ARDS survivors. Given the COVID-19 pandemic, telemedicine was shortly implemented and 62% of the visits were virtual. Median age (IQR) was 59.1 (49.2-71.6), 59% were male, with near equal Caucasian and African American distribution. All patients who had an in-person visit were seen by a critical care physician and advance practice provider, pharmacist, psychiatrist and physical therapist during the visit. 36% screened positive for anxiety or depression as identified by the Patient Health Questionnaire-4 (PHQ- 4), and 11% screened positive for post-traumatic stress disorder (PTSD) identified by the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5). Of the patients seen with in-person visit, 45% had either mild or moderate cognitive impairment identified by the Montreal Cognitive Assessment (MOCA). Median 6-minute walk distance was 66% predicted. Median FEV1, FVC, and DLCO was 86, 80, and 60% predicted respectively. From the 61% of patients who were working and 91% who were driving prior to hospitalization, only 22% and 65% had returned to those activities respectively. Thirty four (56%) patients had at least one referral made, with some patients receiving up to 6 referrals. Conclusion: A high prevalence of PICS and social impairments were identified in ICU survivors at a PIRC. Incorporating an inter-disciplinary team approach and standardized surveys were imperative to recognize these impairments in order to support return to the best state of recovery possible.
{"title":"Aiding the Recovery of ICU Survivors: Creation and Implementation of a Post-ICU Recovery Clinic","authors":"M. Biehl, K. Sarin, E. Bishop, J. Veith, M. Holztrager, K. Bash, J. O’Brien, H. Khouli","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2850","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2850","url":null,"abstract":"Introduction: Advancements in critical care medicine have led to increase in Intensive Care Unit (ICU) survival. ICU survivors often experience cognitive, mental and physical impairments as part of a condition called Post- Intensive Care Syndrome (PICS). While there are several ICU follow-up programs, there is variability in their structure and approach. We describe the creation and implementation of a Post-ICU Recovery Clinic (PIRC). Methods: A retrospective observational study was conducted and included all patients seen in a PIRC of a quaternary health system from December 2019 to September 2020. PIRC visit variables included scores on several validated questionnaires screening for mental health and cognitive disorders, 6-minute walk test, pulmonary function test, change in occupational and driving status, and referrals made during PIRC visit. Statistics reported reflect exclusion of the missing data points. Results: The criteria utilized for patient selection was circulatory shock, acute respiratory distress syndrome (ARDS), mechanical ventilation >7 days, ICU admission >7 days, delirium, cardiac arrest and COVID-19 with ICU stay >2 days. A total of 63 patients were seen in PIRC, 41% of those were ARDS survivors. Given the COVID-19 pandemic, telemedicine was shortly implemented and 62% of the visits were virtual. Median age (IQR) was 59.1 (49.2-71.6), 59% were male, with near equal Caucasian and African American distribution. All patients who had an in-person visit were seen by a critical care physician and advance practice provider, pharmacist, psychiatrist and physical therapist during the visit. 36% screened positive for anxiety or depression as identified by the Patient Health Questionnaire-4 (PHQ- 4), and 11% screened positive for post-traumatic stress disorder (PTSD) identified by the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5). Of the patients seen with in-person visit, 45% had either mild or moderate cognitive impairment identified by the Montreal Cognitive Assessment (MOCA). Median 6-minute walk distance was 66% predicted. Median FEV1, FVC, and DLCO was 86, 80, and 60% predicted respectively. From the 61% of patients who were working and 91% who were driving prior to hospitalization, only 22% and 65% had returned to those activities respectively. Thirty four (56%) patients had at least one referral made, with some patients receiving up to 6 referrals. Conclusion: A high prevalence of PICS and social impairments were identified in ICU survivors at a PIRC. Incorporating an inter-disciplinary team approach and standardized surveys were imperative to recognize these impairments in order to support return to the best state of recovery possible.","PeriodicalId":255004,"journal":{"name":"TP55. TP055 MECHANICAL VENTILATION, ICU MANAGEMENT, AND CV","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125872948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2810
P. Soni, V. Kumar, V. T. Gonuguntla, S. Musty, K. Gupta, K. Chawla, Y. Kupfer
{"title":"Safety of Non-Invasive Ventilation in Patients with Altered Mental Status","authors":"P. Soni, V. Kumar, V. T. Gonuguntla, S. Musty, K. Gupta, K. Chawla, Y. Kupfer","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2810","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2810","url":null,"abstract":"","PeriodicalId":255004,"journal":{"name":"TP55. TP055 MECHANICAL VENTILATION, ICU MANAGEMENT, AND CV","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129295728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2849
A. Patel, A. Lucia Fuentes, A. Malhotra, L. C. Crotty Alexander
Introduction: The acute physiology, age, chronic Health Evaluation (APACHE) II score has been used to assess risk of mortality in admitted intensive care unit (ICU) patients since 1985. There are few examples of a longitudinal correlation over time. As the scores rises from 0 to 71, risk of mortality increases. For this study, other scores were also considered - SOFA (Sequential Organ Failure Assessment) was excluded due to a lack of variable diversity and small range of values. APACHE III and IV are more complex scores with additional variables, such that calculating daily scores manually was impracticable. APACHE II has consistent calibration compared to III and IV. We assessed whether APACHE III and IV scores had any additional benefit over APACHE II. Methods: APACHE II score was used to determine clinical severity daily of sixteen critically ill COVID-19 patients and compared to daily changes in cytokine levels. If any studies were unavailable for a given day, data was pulled from a maximum of 24 hours before or after the day of interest. Although GCS (Glasgow Coma Scale) is a large part of the score, and difficult to assess in an intubated patient, however it contributed to documenting sedation and intubation state. Results: APACHE II score assessed clinical severity daily in COVID-19 more effectively relative to SOFA. The wide score range allowed comparison of patients without overlap, as compared to SOFA which has a range of 0-24. With a larger range of 0-71, we believe that it increased the sensitivity for detection of small changes in clinical status. We analyzed APACHE II in context of absolute neutrophil count, plasma cytokine levels, as well as neutrophil functional studies. For our study, APACHE II, not SOFA, was helpful in demonstrating changes in severity of illness, which correlated with some of these assessments. For example, APACHE II showed a significant linear correlation with pro-inflammatory cytokine IL-8 in plasma (r2=0.47, p=0.0017;Fig 1). Conclusion: APACHE II was able to define the severity of illness in COVID-19 patients on a daily basis. APACHE II score allowed us to tie immunophenotyping to clinical disease severity over time and was helpful in broadening our approach to data comparison with clinical status. This was a pilot study to assess the ability of APACHE II to track severity of illness, but in the future, we plan to correlate APACHE II in a larger cohort of a variety of ARDS patients.
简介自 1985 年以来，急性生理学、年龄、慢性健康评估（APACHE）II 评分一直被用于评估重症监护室（ICU）住院病人的死亡风险。很少有纵向相关性的例子。随着分数从 0 升至 71，死亡风险也随之增加。在这项研究中，还考虑了其他评分--SOFA（序贯器官衰竭评估）因缺乏变量多样性和数值范围较小而被排除在外。APACHE III 和 IV 评分较为复杂，带有额外的变量，因此手动计算每日评分并不可行。与 APACHE III 和 IV 相比，APACHE II 的校准比较一致。我们评估了 APACHE III 和 IV 评分是否比 APACHE II 更有优势。方法：使用 APACHE II 评分确定 16 名 COVID-19 重症患者每日的临床严重程度，并与细胞因子水平的每日变化进行比较。如果某天没有任何研究数据，则从该天前后最多 24 小时的数据中提取。尽管GCS（格拉斯哥昏迷量表）是评分的重要组成部分，而且很难对插管患者进行评估，但它有助于记录镇静和插管状态。结果与 SOFA 相比，APACHE II 评分能更有效地评估 COVID-19 每天的临床严重程度。与 SOFA（评分范围为 0-24）相比，APACHE II 的评分范围更广，可以在不重叠的情况下对患者进行比较。由于 0-71 分的范围更大，我们认为它提高了检测临床状态微小变化的灵敏度。我们结合中性粒细胞绝对计数、血浆细胞因子水平以及中性粒细胞功能研究对 APACHE II 进行了分析。在我们的研究中，APACHE II（而非 SOFA）有助于显示病情严重程度的变化，这与其中一些评估结果相关。例如，APACHE II 与血浆中的促炎细胞因子 IL-8 呈显著线性相关（r2=0.47，p=0.0017；图 1）。结论APACHE II 能够确定 COVID-19 患者每天的病情严重程度。APACHE II 评分使我们能够将免疫分型与临床疾病的严重程度结合起来，并有助于拓宽我们与临床状况进行数据比较的方法。这是一项评估 APACHE II 追踪病情严重程度能力的试验性研究，但我们计划将来在更大的 ARDS 患者群中对 APACHE II 进行相关分析。
{"title":"Using APACHE Longitudinally in ARDS to Assess Disease Severity","authors":"A. Patel, A. Lucia Fuentes, A. Malhotra, L. C. Crotty Alexander","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2849","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2849","url":null,"abstract":"Introduction: The acute physiology, age, chronic Health Evaluation (APACHE) II score has been used to assess risk of mortality in admitted intensive care unit (ICU) patients since 1985. There are few examples of a longitudinal correlation over time. As the scores rises from 0 to 71, risk of mortality increases. For this study, other scores were also considered - SOFA (Sequential Organ Failure Assessment) was excluded due to a lack of variable diversity and small range of values. APACHE III and IV are more complex scores with additional variables, such that calculating daily scores manually was impracticable. APACHE II has consistent calibration compared to III and IV. We assessed whether APACHE III and IV scores had any additional benefit over APACHE II. Methods: APACHE II score was used to determine clinical severity daily of sixteen critically ill COVID-19 patients and compared to daily changes in cytokine levels. If any studies were unavailable for a given day, data was pulled from a maximum of 24 hours before or after the day of interest. Although GCS (Glasgow Coma Scale) is a large part of the score, and difficult to assess in an intubated patient, however it contributed to documenting sedation and intubation state. Results: APACHE II score assessed clinical severity daily in COVID-19 more effectively relative to SOFA. The wide score range allowed comparison of patients without overlap, as compared to SOFA which has a range of 0-24. With a larger range of 0-71, we believe that it increased the sensitivity for detection of small changes in clinical status. We analyzed APACHE II in context of absolute neutrophil count, plasma cytokine levels, as well as neutrophil functional studies. For our study, APACHE II, not SOFA, was helpful in demonstrating changes in severity of illness, which correlated with some of these assessments. For example, APACHE II showed a significant linear correlation with pro-inflammatory cytokine IL-8 in plasma (r2=0.47, p=0.0017;Fig 1). Conclusion: APACHE II was able to define the severity of illness in COVID-19 patients on a daily basis. APACHE II score allowed us to tie immunophenotyping to clinical disease severity over time and was helpful in broadening our approach to data comparison with clinical status. This was a pilot study to assess the ability of APACHE II to track severity of illness, but in the future, we plan to correlate APACHE II in a larger cohort of a variety of ARDS patients.","PeriodicalId":255004,"journal":{"name":"TP55. TP055 MECHANICAL VENTILATION, ICU MANAGEMENT, AND CV","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128075524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2847
S. Badour, J. Abi Jaoude, T. Schwann
{"title":"Cardiopulmonary Bypass Effect on the Development of Postoperative Pulmonary Complications and on Short, Intermediate and Long Term Mortality in Cardiac Surgery","authors":"S. Badour, J. Abi Jaoude, T. Schwann","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2847","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2847","url":null,"abstract":"","PeriodicalId":255004,"journal":{"name":"TP55. TP055 MECHANICAL VENTILATION, ICU MANAGEMENT, AND CV","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131826330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2833
D. Kumar, F. Shaikh, F. Warsha, S. Haider
{"title":"Fluid Management in Diabetic Ketoacidosis; Comparing Balanced Fluids to Normal saline.","authors":"D. Kumar, F. Shaikh, F. Warsha, S. Haider","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2833","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2833","url":null,"abstract":"","PeriodicalId":255004,"journal":{"name":"TP55. TP055 MECHANICAL VENTILATION, ICU MANAGEMENT, AND CV","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115167732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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