{"created":"2024-09-26T05:00:23.950542+00:00","id":2000228,"links":{},"metadata":{"_buckets":{"deposit":"74fbd643-9bed-469b-ad66-e199d5bee951"},"_deposit":{"created_by":52,"id":"2000228","owner":"52","owners":[52],"pid":{"revision_id":0,"type":"depid","value":"2000228"},"status":"published"},"_oai":{"id":"oai:tokushima-u.repo.nii.ac.jp:02000228","sets":["1713853213384:1713853295607"]},"author_link":["1193","947"],"control_number":"2000228","item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2023-04-20","bibliographicIssueDateType":"Issued"},"bibliographicPageStart":"156","bibliographicVolumeNumber":"27","bibliographic_titles":[{"bibliographic_title":"Critical Care","bibliographic_titleLang":"en"}]}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"Background\nThere is insufficient evidence to guide ventilatory targets in acute brain injury (ABI). Recent studies have shown associations between mechanical power (MP) and mortality in critical care populations. We aimed to describe MP in ventilated patients with ABI, and evaluate associations between MP and clinical outcomes.\nMethods\nIn this preplanned, secondary analysis of a prospective, multi-center, observational cohort study (ENIO, NCT03400904), we included adult patients with ABI (Glasgow Coma Scale ≤ 12 before intubation) who required mechanical ventilation (MV) ≥ 24 h. Using multivariable log binomial regressions, we separately assessed associations between MP on hospital day (HD)1, HD3, HD7 and clinical outcomes: hospital mortality, need for reintubation, tracheostomy placement, and development of acute respiratory distress syndrome (ARDS).\nResults\nWe included 1217 patients (mean age 51.2 years [SD 18.1], 66% male, mean body mass index [BMI] 26.3 [SD 5.18]) hospitalized at 62 intensive care units in 18 countries. Hospital mortality was 11% (n = 139), 44% (n = 536) were extubated by HD7 of which 20% (107/536) required reintubation, 28% (n = 340) underwent tracheostomy placement, and 9% (n = 114) developed ARDS. The median MP on HD1, HD3, and HD7 was 11.9 J/min [IQR 9.2–15.1], 13 J/min [IQR 10–17], and 14 J/min [IQR 11–20], respectively. MP was overall higher in patients with ARDS, especially those with higher ARDS severity. After controlling for same-day pressure of arterial oxygen/fraction of inspired oxygen (P/F ratio), BMI, and neurological severity, MP at HD1, HD3, and HD7 was independently associated with hospital mortality, reintubation and tracheostomy placement. The adjusted relative risk (aRR) was greater at higher MP, and strongest for: mortality on HD1 (compared to the HD1 median MP 11.9 J/min, aRR at 17 J/min was 1.22, 95% CI 1.14–1.30) and HD3 (1.38, 95% CI 1.23–1.53), reintubation on HD1 (1.64; 95% CI 1.57–1.72), and tracheostomy on HD7 (1.53; 95%CI 1.18–1.99). MP was associated with the development of moderate-severe ARDS on HD1 (2.07; 95% CI 1.56–2.78) and HD3 (1.76; 95% CI 1.41–2.22).\nConclusions\nExposure to high MP during the first week of MV is associated with poor clinical outcomes in ABI, independent of P/F ratio and neurological severity. Potential benefits of optimizing ventilator settings to limit MP warrant further investigation.","subitem_description_language":"en","subitem_description_type":"Abstract"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"Springer Nature","subitem_publisher_language":"en"},{"subitem_publisher":"BioMed Central","subitem_publisher_language":"en"}]},"item_10001_rights_15":{"attribute_name":"権利情報","attribute_value_mlt":[{"subitem_rights":"This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.","subitem_rights_language":"en"}]},"item_10001_source_id_9":{"attribute_name":"収録物ID","attribute_value_mlt":[{"subitem_source_identifier":"13648535","subitem_source_identifier_type":"ISSN"}]},"item_10001_version_type_20":{"attribute_name":"出版タイプ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_1715043197608":{"attribute_name":"アクセス権","attribute_value_mlt":[{"subitem_access_right":"open access","subitem_access_right_uri":"http://purl.org/coar/access_right/c_abf2"}]},"item_1722929371688":{"attribute_name":"出版社版DOI","attribute_value_mlt":[{"subitem_relation_name":[{"subitem_relation_name_language":"ja","subitem_relation_name_text":"10.1186/s13054-023-04410-z"}],"subitem_relation_type_id":{"subitem_relation_type_id_text":"https://doi.org/10.1186/s13054-023-04410-z","subitem_relation_type_select":"DOI"}}]},"item_1723180141928":{"attribute_name":"EID","attribute_value_mlt":[{"subitem_identifier_type":"URI","subitem_identifier_uri":"407996"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"Wahlster, Sarah","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"Sharma, Monisha","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"Taran, Shaurya","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"Town, James A.","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"Stevens, Robert D.","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"Cinotti, Raphaël","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"Asehoune, Karim","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"Pelosi, Paolo","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"Robba, Chiara","creatorNameLang":"en"}]},{"creatorAffiliations":[{"affiliationNameIdentifiers":[{"affiliationNameIdentifier":"","affiliationNameIdentifierScheme":"ISNI","affiliationNameIdentifierURI":"http://www.isni.org/isni/"}],"affiliationNames":[{"affiliationName":"","affiliationNameLang":"ja"}]}],"creatorNames":[{"creatorName":"大藤, 純","creatorNameLang":"ja"},{"creatorName":"オオトウ, ジュン","creatorNameLang":"ja-Kana"},{"creatorName":"Oto, Jun","creatorNameLang":"en"}],"familyNames":[{"familyName":"大藤","familyNameLang":"ja"},{"familyName":"オオトウ","familyNameLang":"ja-Kana"},{"familyName":"Oto","familyNameLang":"en"}],"givenNames":[{"givenName":"純","givenNameLang":"ja"},{"givenName":"ジュン","givenNameLang":"ja-Kana"},{"givenName":"Jun","givenNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"1193","nameIdentifierScheme":"WEKO"},{"nameIdentifier":"60684/profile-ja.html","nameIdentifierScheme":"徳島大学 教育研究者総覧","nameIdentifierURI":"http://pub2.db.tokushima-u.ac.jp/ERD/person/60684/profile-ja.html"},{"nameIdentifier":"40346606","nameIdentifierScheme":"e-Rad","nameIdentifierURI":"https://nrid.nii.ac.jp/ja/search/?qm=40346606"}]},{"creatorAffiliations":[{"affiliationNameIdentifiers":[{"affiliationNameIdentifier":"","affiliationNameIdentifierScheme":"ISNI","affiliationNameIdentifierURI":"http://www.isni.org/isni/"}],"affiliationNames":[{"affiliationName":"","affiliationNameLang":"ja"}]}],"creatorNames":[{"creatorName":"上野, 義豊","creatorNameLang":"ja"},{"creatorName":"ウエノ, ヨシトヨ","creatorNameLang":"ja-Kana"},{"creatorName":"Ueno, Yoshitoyo","creatorNameLang":"en"}],"familyNames":[{"familyName":"上野","familyNameLang":"ja"},{"familyName":"ウエノ","familyNameLang":"ja-Kana"},{"familyName":"Ueno","familyNameLang":"en"}],"givenNames":[{"givenName":"義豊","givenNameLang":"ja"},{"givenName":"ヨシトヨ","givenNameLang":"ja-Kana"},{"givenName":"Yoshitoyo","givenNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"947","nameIdentifierScheme":"WEKO"},{"nameIdentifier":"349361/profile-ja.html","nameIdentifierScheme":"徳島大学 教育研究者総覧","nameIdentifierURI":"http://pub2.db.tokushima-u.ac.jp/ERD/person/349361/profile-ja.html"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_access","date":[{"dateType":"Available","dateValue":"2024-01-01"}],"displaytype":"detail","filename":"cc_27_156.pdf","filesize":[{"value":"2.1 MB"}],"format":"application/pdf","licensetype":"license_0","mimetype":"application/pdf","url":{"objectType":"fulltext","url":"https://tokushima-u.repo.nii.ac.jp/record/2000228/files/cc_27_156.pdf"},"version_id":"d5752db9-0f15-4aa6-b6c0-eb15d2019e45"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"Acute brain injury","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Mechanical power","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Acute respiratory distress syndrome","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Mechanical ventilation","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Traumatic brain injury","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Subarachnoid hemorrhage","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Acute ischemic stroke","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Intracranial hemorrhage","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"eng"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"Utilization of mechanical power and associations with clinical outcomes in brain injured patients : a secondary analysis of the extubation strategies in neuro-intensive care unit patients and associations with outcome (ENIO) trial","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"Utilization of mechanical power and associations with clinical outcomes in brain injured patients : a secondary analysis of the extubation strategies in neuro-intensive care unit patients and associations with outcome (ENIO) trial","subitem_title_language":"en"}]},"item_type_id":"40001","owner":"52","path":["1713853295607"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2024-10-24"},"publish_date":"2024-10-24","publish_status":"0","recid":"2000228","relation_version_is_last":true,"title":["Utilization of mechanical power and associations with clinical outcomes in brain injured patients : a secondary analysis of the extubation strategies in neuro-intensive care unit patients and associations with outcome (ENIO) trial"],"weko_creator_id":"52","weko_shared_id":-1},"updated":"2025-01-31T05:23:05.496700+00:00"}