Potentially modifiable ventilation factors associated with outcome in neurocritical care vs. non-neurocritical care patients: Rational and protocol for a patient-level analysis of PRoVENT, PRoVENT-iMiC and ENIO (PRIME).

Fecha de publicación: 01/05/2025 Fecha Ahead of Print: 15/02/2025

Autores de IIS La Fe

Guido Mazzinari

Autor

Participantes ajenos a IIS La Fe

Serafini SC
Cinotti R
Asehnoune K
Battaglini D
Robba C
Neto AS
Pisani L
Tschernko EM
Schultz MJ
PRoVENT, the PRoVENT–iMiC and ENIO, investigators

Grupos

Medicina Perioperatoria, Anestesiología y Reanimación

Abstract

INTRODUCTION: Ventilator settings and ventilation variables and parameters vary between neurocritical care and non-neurocritical care patients. We aim to compare ventilation management in neurocritical care patients versus non-neurocritical care patients under invasive mechanical ventilation support, and to determine which factors related to ventilatory management have an independent association with outcome in neurocritical patients. METHODS AND ANALYSIS: We meta-analyze harmonized individual patient data from three observational studies ('PRactice of VENTilation in critically ill patients without ARDS' [PRoVENT], 'PRactice of VENTilation in critically ill patients in Middle-income Countries' [PRoVENT-iMiC] and 'Extubation strategies and in neuro-intensive care unit patients and associations with outcomes' [ENIO]), pooled into a database named 'PRIME'. The primary endpoint is all cause ICU mortality. Secondary endpoints are key ventilator settings and ventilation variables and parameters. To identify potentially modifiable and non-modifiable factors contributing to ICU mortality, a multivariable model will be built using demographic factors, comorbidities, illness severities, and respiratory and laboratorial variables. In analyses examining the impact of ventilatory variables on outcome, we will estimate the relative risk of ICU mortality for neurocritical and non-neurocritical care patients by dividing the study population based on key ventilator variables and parameters. ETHICS AND DISSEMINATION: This meta-analysis will address a clinically significant research question by comparing neurocritical care with non-neurocritical care patients. As this is a meta-analysis, additional ethical committee approval is not required. Findings will be disseminated to the scientific community through abstracts and original articles in peer-reviewed journals. Furthermore, the PRIME database will be made accessible for further post-hoc analyses. REGISTRATION: PROVENT, PROVENT-iMiC and ENIO, and the pooled database PRIME are registered at clinicaltrials.gov (NCT01868321 for PRoVENT, NCT03188770 for PRoVENT-iMiC, and NCT03400904 for ENIO, and for PRIME is pending).

Datos de la publicación

ISSN/ISSNe:: 2341-1929, 2341-1929
Tipo:: Article
Páginas:: 501690-501690
DOI:: 10.1016/j.redare.2025.501690
PubMed:: 39961531

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Métricas

Filiaciones

Serafini SC:: Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genova, Italy

Clinical Department of Cardiothoracic Vascular Surgery Anesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria
Cinotti R:: Department of Anesthesiology and Critical Care, CHU Nantes, Nantes Université, Nantes, France
Asehnoune K:: Department of Anesthesiology and Critical Care, CHU Nantes, Nantes Université, Nantes, France
Battaglini D:: Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genova, Italy

Anesthesia and Critical Care, San Martino Policlinic Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy
Robba C:: Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genova, Italy

Anesthesia and Critical Care, San Martino Policlinic Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy
Neto AS:: Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

Department of Critical Care, Austin Hospital, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia

Department of Critical Care, Data Analytics Research and Evaluation Centre, University of Melbourne, Melbourne, Victoria, Australia

Department of Critical Care, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
Pisani L:: Anesthesia and Critical Care, Giovanni XXIII Policlinic Hospital, Bari, Italy

Mahidol Oxford Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
Mazzinari G:: Department of Anesthesiology, Hospital Universitario la Fe, Valencia, Spain

Perioperative Medicine Research Group, Instituto de Investigación Sanitaria, Valencia, Spain

Department of Statistics and Operational Research, Universidad de Valencia, Valencia, Spain
Tschernko EM:: Clinical Department of Cardiothoracic Vascular Surgery Anesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria
Schultz MJ:: Clinical Department of Cardiothoracic Vascular Surgery Anesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria

Mahidol Oxford Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand

Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom

Keywords

Cuidados neurocríticos; Factores modificables; ICU; ICU mortality; Meta-analysis; Metaanálisis; Modifiable factors; Mortalidad; Mortalidad en la UCI; Mortality; Neurocritical care; Neurocritical patients; Pacientes neurocríticos; Soporte ventilatorio; UCI; Ventilación; Ventilation; Ventilatory support

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