Diagnosing acute lung injury in the critically ill: a national survey among critical care physicians

Background: Incidence reports on acute lung injury (ALI) vary widely. An insight into the diagnostic preferences of critical care physicians when diagnosing ALI may improve identification of the ALI patient population. Methods: Critical care physicians in the Netherlands were surveyed using vignette...

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Bibliographic Details
Published in:Acta anaesthesiologica Scandinavica 2009-11, Vol.53 (10), p.1293-1299
Main Authors: VLAAR, A. P. J., HONSELAAR, W. B., BINNEKADE, J. M., GROENEVELD, A. B., SPRONK, P. E., SCHULTZ, M. J., JUFFERMANS, N. P.
Format: Article
Language:English
Subjects:
Acute Lung Injury - diagnosis
Adult
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthesiology - methods
Biological and medical sciences
Cardiac Output
Critical Care - methods
Critical Illness
Female
Humans
Internal Medicine - methods
Logistic Models
Lung Compliance
Male
Medical sciences
Netherlands
Partial Pressure
Positive-Pressure Respiration
Pulmonary Wedge Pressure
Surveys and Questionnaires
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Summary:Background: Incidence reports on acute lung injury (ALI) vary widely. An insight into the diagnostic preferences of critical care physicians when diagnosing ALI may improve identification of the ALI patient population. Methods: Critical care physicians in the Netherlands were surveyed using vignettes involving hypothetical patients and a questionnaire. The vignettes varied in seven diagnostic determinants based on the North American European Consensus Conference and the lung injury score. Preferences were analyzed using a mixed‐effects logistic regression model and presented as an odds ratio (OR) with a 95% confidence interval. Results: From 243 surveys sent to 30 hospitals, 101 were returned (42%). ORs were as follows: chest X‐ray consistent with ALI: OR 1.7 (1.3–2.3), high positive end‐expiratory pressure (PEEP) (15 cmH2O): OR 5.0 (3.9–6.6), low pulmonary artery occlusion pressures (PAOP) (
ISSN:0001-5172
1399-6576
DOI:10.1111/j.1399-6576.2009.02102.x