Mechanical Ventilation and ARDS in the ED: A Multicenter, Observational, Prospective, Cross-sectional Study

Area of Science:

• Critical Care Medicine
• Emergency Medicine
• Respiratory Medicine

Background:

• Limited data exist on mechanical ventilation and Acute Respiratory Distress Syndrome (ARDS) management within the Emergency Department (ED).
• The ED presents a critical opportunity for early ARDS prevention and treatment strategies.

Purpose of the Study:

• To analyze mechanical ventilation practices in the ED.
• To determine the incidence and predictors of ARDS following ED admission.

Main Methods:

• A multicenter, observational, prospective cohort study involving 219 patients receiving mechanical ventilation in the ED.
• Primary outcome: incidence of ARDS post-admission.
• Multivariable logistic regression to identify ARDS predictors.

Main Results:

• Lung-protective ventilation was used in 55.7% of patients.
• The incidence of ARDS post-ED admission was 14.7%, with a mean onset of 2.3 days.
• Higher illness severity and pre-ED intubation were associated with ARDS progression.

Conclusions:

• Lung-protective ventilation is infrequently employed in the ED, irrespective of ARDS status.
• ARDS development post-ED admission is common, occurs early, and leads to worse outcomes.
• ED-based interventions are necessary to prevent ARDS onset and reduce its severity.