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Diagnosing acute lung injury in the critically ill: a national survey among critical care physicians.

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  • معلومة اضافية
    • المصدر:
      Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 0370270 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1399-6576 (Electronic) Linking ISSN: 00015172 NLM ISO Abbreviation: Acta Anaesthesiol Scand Subsets: MEDLINE
    • بيانات النشر:
      Publication: Oxford, UK : Wiley-Blackwell
      Original Publication: Aarhus, Denmark : Universitetsforlaget, 1957-
    • الموضوع:
    • نبذة مختصرة :
      Background: Incidence reports on acute lung injury (ALI) vary widely. An insight into the diagnostic preferences of critical care physicians when diagnosing ALI may improve identification of the ALI patient population.
      Methods: Critical care physicians in the Netherlands were surveyed using vignettes involving hypothetical patients and a questionnaire. The vignettes varied in seven diagnostic determinants based on the North American European Consensus Conference and the lung injury score. Preferences were analyzed using a mixed-effects logistic regression model and presented as an odds ratio (OR) with a 95% confidence interval.
      Results: From 243 surveys sent to 30 hospitals, 101 were returned (42%). ORs were as follows: chest X-ray consistent with ALI: OR 1.7 (1.3-2.3), high positive end-expiratory pressure (PEEP) (15 cmH(2)O): OR 5.0 (3.9-6.6), low pulmonary artery occlusion pressures (PAOP) (<18 mmHg): OR 4.7 (3.6-6.1), low compliance (30 ml/cmH(2)O): OR 0.7 (0.5-0.9), low PaO(2)/FiO(2) (<250 mmHg): OR 9.2 (6.9-12.3), absence of heart failure: OR 1.2 (0.9-1.5), presence of a risk factor for ALI (sepsis): OR 1.0 (0.8-1.3). The questionnaire revealed that critical care physicians with an anesthesiology background differed from physicians with an internal medicine background with regard to hemodynamic variables when considering an ALI diagnosis (P<0.05).
      Conclusions: Dutch critical care physicians consider the PEEP level, but not the presence of a risk factor for ALI, as an important factor to diagnose ALI. Background specialty of critical care physicians influences diagnostic preferences and may account for variance in the reported incidence of ALI.
    • الموضوع:
      Date Created: 20090902 Date Completed: 20100126 Latest Revision: 20151119
    • الموضوع:
      20250114
    • الرقم المعرف:
      10.1111/j.1399-6576.2009.02102.x
    • الرقم المعرف:
      19719815