Competing interestsJ-LV has received grants from molecular weight calculator Edwards Lifesciences and Pulsion Medical Systems. AR has received lecture fees from LiDCO and advisory board fees from Cheetah and Edwards. AP is a member of the medical advisory board of Pulsion Medical Systems and consultant to BMEYE. GSM is a member of the medical advisory board of Pulsion Medical Systems. GDR has no conflicts related to this manuscript. BV is an advisor to, and has received lecture fees from, Edwards. MRP is a paid advisor to LiDCO Ltd, Edwards LifeSciences Inc., and Applied Physiology; he has stock options with LiDCO and Cheetah Medical and has received honoraria from Cheetah Medical. CKH has received lecture fees and research grants from Pulsion Medical Systems and Edwards Lifesciences.
J-LT is a member of the medical advisory board of Pulsion Medical Systems. W-PdeB has received research grants from Transonic Systems Inc. and Pulsion Medical Systems. SS has received research grants from Vygon and Vythec. AV-B has received research grants from General Electric and Maquet. DDeB has received grants and material for studies from Edwards Lifesciences, Pulsion Medical Systems, LiDCO and Vytech and honoraria for lectures from Edwards Lifesciences and Pulsion Medical Systems. KRW has no conflicts related to this manuscript. MM is a member of the medical advisory board of Pulsion Medical Systems. MS is on the Advisory Board for Deltex Medical and Covidien; Deltex Medical provide unrestricted research grants.
During the study period 178 patients with diffuse viral pneumonitis requiring MV were admitted.
They were 44 �� 15 years of age, with Acute Physiology And Chronic Health Evaluation II (APACHE II) scores of 18 �� 7, and most frequent comorbidities were obesity (26%), previous respiratory disease (24%) and immunosuppression (16%). Non-invasive ventilation (NIV) was applied in 49 (28%) patients on admission, but 94% were later intubated.Acute respiratory distress syndrome (ARDS) was present throughout the entire ICU stay in the whole group (mean PaO2/FIO2 170 �� 25). Tidal-volumes used were 7.8 to 8.1 ml/kg (ideal body weight), plateau pressures always remained < 30 cmH2O, without differences between survivors and non-survivors; and mean positive end-expiratory pressure (PEEP) levels used were between 8 to 12 cm H2O.
Rescue therapies, like recruitment maneuvers (8 to 35%), prone positioning (12 to 24%) and tracheal gas insufflation (3%) were frequently Carfilzomib applied. At all time points, pH, platelet count, lactate dehydrogenase assay (LDH) and Sequential Organ Failure Assessment (SOFA) differed significantly between survivors and non-survivors. Lack of recovery of platelet count and persistence of leukocytosis were characteristic of non-survivors. Mortality was high (46%); and length of MV was 10 (6 to 17) days.