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A multi-faceted strategy to reduce ventilation-associated mortality in brain-injured patients. The BI-VILI project: a nationwide quality improvement project

Overview of attention for article published in Intensive Care Medicine, March 2017
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (78th percentile)
  • Average Attention Score compared to outputs of the same age and source

Citations

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66 Mendeley
Title
A multi-faceted strategy to reduce ventilation-associated mortality in brain-injured patients. The BI-VILI project: a nationwide quality improvement project
Published in
Intensive Care Medicine, March 2017
DOI 10.1007/s00134-017-4764-6
Pubmed ID
Authors

Karim Asehnoune, Ségolène Mrozek, Pierre François Perrigault, Philippe Seguin, Claire Dahyot-Fizelier, Sigismond Lasocki, Anne Pujol, Mathieu Martin, Russel Chabanne, Laurent Muller, Jean Luc Hanouz, Emmanuelle Hammad, Bertrand Rozec, Thomas Kerforne, Carole Ichai, Raphael Cinotti, Thomas Geeraerts, Djillali Elaroussi, Paolo Pelosi, Samir Jaber, Marie Dalichampt, Fanny Feuillet, Véronique Sebille, Antoine Roquilly

Abstract

We assessed outcomes in brain-injured patients after implementation of a multi-faceted approach to reduce respiratory complications in intensive care units. Prospective nationwide before-after trial. Consecutive adults with acute brain injury requiring mechanical ventilation for ≥24 h in 20 French intensive care units (ICUs) were included. The management of invasive ventilation in brain-injured patients admitted between 1 July 2013 and 31 October 2013 (4 months) was monitored and analysed. After the baseline period (1 November 2013-31 December 2013), ventilator settings and decision to extubate were selected as targets to hasten weaning from invasive ventilation. During the intervention period, low tidal volume (≤7 ml/kg), moderate positive end-expiratory pressure (PEEP, 6-8 cm H2O) and an early extubation protocol were recommended. The primary endpoint was the number of days free of invasive ventilation at day 90. Comparisons were performed between the two periods and between the compliant and non-compliant groups. A total of 744 patients from 20 ICUs were included (391 pre-intervention; 353 intervention). No difference in the number of invasive ventilation-free days at day 90 was observed between the two periods [71 (0-80) vs. 67 (0-80) days; P = 0.746]. Compliance with the complete set of recommendations increased from 8 (2%) to 52 (15%) patients after the intervention (P < 0.001). At day 90, the number of invasive ventilation-free days was higher in the 60 (8%) patients whose care complied with recommendations than in the 684 (92%) patients whose care deviated from recommendations [77 (66-82) and 71 (0-80) days, respectively; P = 0.03]. The mortality rate was 10% in the compliant group and 26% in the non-compliant group (P = 0.023). Both multivariate analysis [hazard ratio (HR) 1.78, 95% confidence interval (95% CI) 1.41-2.26; P < 0.001] and propensity score-adjusted analysis (HR 2.25, 95% CI 1.56-3.26, P < 0.001) revealed that compliance was an independent factor associated with the reduction in the duration of mechanical ventilation. Adherence to recommendations for low tidal volume, moderate PEEP and early extubation seemed to increase the number of ventilator-free days in brain-injured patients, but inconsistent adoption limited their impact. Trail registration number: NCT01885507.

Twitter Demographics

The data shown below were collected from the profiles of 12 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 66 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 66 100%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 8 12%
Student > Master 8 12%
Other 8 12%
Researcher 8 12%
Student > Doctoral Student 6 9%
Other 16 24%
Unknown 12 18%
Readers by discipline Count As %
Medicine and Dentistry 33 50%
Nursing and Health Professions 9 14%
Social Sciences 2 3%
Psychology 1 2%
Agricultural and Biological Sciences 1 2%
Other 4 6%
Unknown 16 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 December 2019.
All research outputs
#2,100,339
of 14,123,595 outputs
Outputs from Intensive Care Medicine
#1,035
of 3,626 outputs
Outputs of similar age
#56,102
of 264,173 outputs
Outputs of similar age from Intensive Care Medicine
#40
of 81 outputs
Altmetric has tracked 14,123,595 research outputs across all sources so far. Compared to these this one has done well and is in the 85th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,626 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.4. This one has gotten more attention than average, scoring higher than 71% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 264,173 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 78% of its contemporaries.
We're also able to compare this research output to 81 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.