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Author Notes:

Correspondence: SeungHye Han; shan@jhsph.edu

Authors' contributions: SH conceived the study, ran the statistical analysis and drafted the manuscript.

GSM assisted with the design of the study and made substantial revisions to the final manuscript.

JPM, CS, KCB and SM made substantial revisions to the final manuscript.

JES assisted with the design of the study, drafted the manuscript, and made substantial revisions to the final manuscript.

All authors have read and approved the manuscript for publication.

Acknowledgements: The authors are grateful to all the study coordinators for recruitment of subjects into the Consortium to Evaluate Lung Edema Genetics (CELEG).

Disclosures: The authors declare that they have no competing interests.

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Research Funding:

This research was supported by a National Heart, Blood, and Lung Institute Specialized Centers of Clinically Oriented Research (SCCOR) grant in Acute Lung Injury SCCOR grant P050 HL.

JES is supported by National Institutes of Health K-23 GMO7-1399.

KCB is supported by Mary Beryl Patch Turnbull Scholar Program.

Short women with severe sepsis-related acute lung injury receive lung protective ventilation less frequently: an observational cohort study

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Journal Title:

Critical Care

Volume:

Volume 15, Number R252

Publisher:

, Pages 1-8

Type of Work:

Article | Final Publisher PDF

Abstract:

Introduction Lung protective ventilation (LPV) has been shown to improve survival and the duration of mechanical ventilation in acute lung injury (ALI) patients. Mortality of ALI may vary by gender, which could result from treatment variability. Whether gender is associated with the use of LPV is not known. Methods A total of 421 severe sepsis-related ALI subjects in the Consortium to Evaluate Lung Edema Genetics from seven teaching hospitals between 2002 and 2008 were included in our study. We evaluated patients' tidal volume, plateau pressure and arterial pH to determine whether patients received LPV during the first two days after developing ALI. The odds ratio of receiving LPV was estimated by a logistic regression model with robust and cluster options. Results Women had similar characteristics as men with the exception of lower height and higher illness severity, as measured by Acute Physiology and Chronic Health Evaluation (APACHE) II score. 225 (53%) of the subjects received LPV during the first two days after ALI onset; women received LPV less frequently than men (46% versus 59%, P < 0.001). However, after adjustment for height and severity of illness (APACHE II), there was no difference in exposure to LPV between men and women (P = 0.262). Conclusions Short people are less likely to receive LPV, which seems to explain the tendency of clinicians to adhere to LPV less strictly in women. Strategies to standardize application of LPV, independent of differences in height and severity of illness, are necessary.

Copyright information:

© 2011 Han et al.; licensee BioMed Central Ltd.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 2.0 Generic License (http://creativecommons.org/licenses/by/2.0/).

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