Ten-year evolution of mechanical ventilation in acute respiratory failure in the hematogical patient admitted to the intensive care unit

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Belenguer-Muncharaz, L. Albert-Rodrigo, A. Ferrandiz-Sellés, G. Cebrián-Graullera" "autores" => array:4 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Belenguer-Muncharaz" "email" => array:1 [ 0 => "belenguer_alb@gva.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "¿" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Albert-Rodrigo" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Ferrandiz-Sellés" ] 3 => array:2 [ "nombre" => "G." 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Table: number of patients alive during this period of time. IMV, invasive mechanical ventilation; NPPV, noninvasive positive pressure ventilation; NPPV OTI, intubated noninvasive ventilation; NPPV-NO OTI, non-intubated noninvasive ventilation." ] ] ] "textoCompleto" => "IntroductionThe prognosis of malignant hematological disease has improved over the last few decades,<a class="elsevierStyleCrossRefs" href="#bib0005">1,2</a> though patients requiring admission to the intensive care unit (ICU) continue to present a high mortality rate.<a class="elsevierStyleCrossRefs" href="#bib0005">1–5</a> The main cause of admission to the ICU is the development of acute respiratory failure (ARF), sometimes requiring ventilatory support,<a class="elsevierStyleCrossRefs" href="#bib0005">1–7</a> due to the appearance of both infectious and non-infectious pulmonary infiltrates.<a class="elsevierStyleCrossRef" href="#bib0040">8</a> On the other hand, mechanical ventilation (MV), and particularly invasive mechanical ventilation (IMV), has been shown to be one of the risk factors of mortality in the ICU.<a class="elsevierStyleCrossRefs" href="#bib0005">1,2</a>The development of noninvasive positive pressure ventilation (NPPV) as a ventilatory support technique has represented a great step forward in the ventilatory care of critically ill patients. NPPV offers a series of benefits,<a class="elsevierStyleCrossRefs" href="#bib0045">9,10</a> since it lessens the need for orotracheal intubation thanks to resting of the muscle burden generated by the respiratory disease underlying ARF; improves oxygenation; and facilitates the elimination of carbon dioxide. As a direct consequence of this, NPPV is able to reduce the incidence of ventilator associated pneumonia (VAP) and shorten patient stay in the ICU and in hospital, especially in immune depressed individuals. Nevertheless, despite these reported benefits and the existence of studies supporting the success of the technique,<a class="elsevierStyleCrossRefs" href="#bib0030">6,10–13</a> NPPV is still less widely used than expected, and IMV remains the gold standard for the ventilation support of these patients.<a class="elsevierStyleCrossRef" href="#bib0025">5</a>The present study analyzes the incidence of ARF in hematological patients admitted to the ICU and requiring mechanical ventilation (invasive and noninvasive), with the purpose of determining whether NPPV is superior to IMV in terms of the development of infections, organ failure, the duration of mechanical ventilation, the duration of stay in the ICU and in hospital, and mortality in the ICU, in hospital, and after 90 days. Likewise, an analysis was made of the incidence of NPPV failure, comparing the same variables between the success and failure groups, and of the factors related to mortality in the NPPV group.Materials and methodsA retrospective observational was carried out, following approval by the hospital Clinical Research Ethics Committee. We included all hematological patients with ARF admitted to the ICU between January 2001 and December 2011, and who required ventilatory support. The hematological diseases mainly comprised acute leukemia (lymphoblastic or myelocytic), non-Hodgkin lymphoma, multiple myeloma, chronic leukemia and Hodgkin's disease. The patients had received chemotherapy, corticosteroid therapy or treatment in the form of hematopoietic precursor cell transplantation. Neutropenia was defined as a leukocyte count of under 1000cells/mm3.Acute respiratory failure was defined as a respiratory frequency (RF) of >30rpm, a partial oxygen pressure (PaO2) of <60mmHg or a partial carbon dioxide pressure (PaCO2) of >45mmHg. Community-acquired pneumonia (CAP) was considered as a lower airway infection characterized by opacifications on the chest X-rays, signs and symptoms of respiratory infection such as fever, cough, pleuritic pain, leukocytosis or leukopenia, and the presence or absence of secretions.<a class="elsevierStyleCrossRef" href="#bib0070">14</a> Hypoxemic conditions were classified as acute lung injury (ALI) or adult respiratory distress syndrome (ARDS), based on the following criteria<a class="elsevierStyleCrossRef" href="#bib0075">15</a>: bilateral infiltration, pulmonary wedge pressure<18mmHg, PaO2/FiO2<300 (ALI) or PaO2/FiO2<200 (ARDS). For the microbiological study we determined soluble antigens in urine, and peripheral blood samples were obtained for blood culture and pneumonia serological testing. Lastly, where possible, we obtained sputum for culture and gram staining. Nasopharyngeal aspiration in turn was performed for determination of the new H1N1 influenza virus – this test being carried out on a routine basis since 2009 in all cases of pneumonia exhibiting an interstitial radiological pattern. Non-bronchoscopic invasive samples (bronchoalveolar lavage and bronchial aspirate), were collected once the patients were intubated. The criteria for sepsis and septic shock were established according to the literature.<a class="elsevierStyleCrossRef" href="#bib0080">16</a>Monitorization and study variablesUpon patient admission, invasive hemodynamic monitorization was carried out, with arterial catheterization and a central venous line. Respiratory monitorization in turn was carried out by recording transcutaneous oxygen saturation (SatcO2) with an Oxisensor Nellcor II D-25 pulsioxymeter (Nellcor® Puritan Bennet Inc., Decasanton, CA, USA), and arterial blood samples were obtained for blood gas determinations using an ABL560 cooxymeter (Radiometer Medical A/S®, Copenhagen, Denmark).Upon patient admission and during the stay in the ICU, we collected personal data and information referred to the diagnosis, severity based on the Simplified Acute Physiology Score (SAPS) 2 and organ failure based on the Sequential Organ Failure Assessment (SOFA). We also recorded the corresponding hemodynamic, respiratory, blood gas and biochemical variables. The duration of stay in the ICU and in hospital was registered, along with the duration of mechanical ventilation. In turn, the complications occurring during stay in the Unit were documented, such as orotracheal intubation, barotrauma, nosocomial infections, the need for tracheotomy and mortality (in the ICU, in hospital, and 90 days after admission). The organ dysfunction rate was assessed based on the Marshall scale,<a class="elsevierStyleCrossRef" href="#bib0085">17</a> which contemplates acute renal failure (with or without hemofiltration) and cardiovascular, hematological, neurological and hepatic failure.Noninvasive ventilatory supportUse was made of the BiPAP Vision respirator<a class="elsevierStyleCrossRef" href="#bib0045">9</a> (Respironics Inc.®, PA, USA) connected to an orofacial or Total face® mask (Respironics Inc.®, PA, USA) with an MR850 active humidification system (Fischer and Payckel Healthcare Ltd., New Zealand). After explaining the technique to the patient, the mask was fitted and we progressively increased the positive end-expiratory pressure (PEEP) and the support pressure to above the PEEP (SP), until achieving a tidal volume (Vt) of 10–15ml/kg and a RF of 25–28rpm, thereby ensuring a minimum SP of 10–15cmH2O and a PEEP of 5–6cmH2O in the first hour of ventilatory support. The oxygen concentration was adjusted until reaching SatcO2 >94%. Once the clinical and/or blood gas condition of the patient improved, gradual ventilator withdrawal was carried out until complete disconnection of NPPV. The changes in FiO2 and SP/PEEP levels were made according to the criterion of the supervising physician. NPPV failure was considered in the presence of any of the following criteria<a class="elsevierStyleCrossRef" href="#bib0045">9</a>: persistence of respiratory effort or hypoxemia, cognitive impairment, or asynchrony with the respirator.Invasive ventilatory supportPatient sedation was carried out with midazolam or propofol associated to morphine, followed by orotracheal intubation and connection to the respirator. Initial parameters: volume control/assist ventilation (CMV/a), Vt: 6–8ml/kg, flow 60l/min, RF: 12–14rpm, FiO2 to achieve SatcO2 94–96%, and minimum PEEP 5cmH2O. Progression of the respiratory process to ARDS required modification of the ventilatory parameters<a class="elsevierStyleCrossRef" href="#bib0090">18</a>: Vt<6ml/kg, plateau pressure<35cmH2O, progressive PEEP and FiO2 as low as possible with the aim of achieving SactO2>94%. After recovery, weaning was started, followed by extubation with the spontaneous breathing test. The modifications of the ventilatory parameters and weaning were carried out by the supervising physician. The patient was considered to have passed the breathing test if there was no hemodynamic or respiratory worsening during 2h. In such cases extubation was considered indicated, always conditioned to medical criterion.The duration of mechanical ventilation included the time (in days) of mechanical ventilation and the weaning time. Hospital stay in turn was documented as the total stay of the patient in the ICU and in hospital. The application of IMV or NPPV, along with the rest of supportive measures (vasoactive drugs, antibiotherapy, renal replacement therapy, blood product transfusion, nutritional support), was regarded as the responsibility of the attending physician at the time of admission, in collaboration with the Department of Hematology.Given the characteristics of the study, informed consent from the patient and/or family was not considered necessary.Statistical analysisThe SPSS version 18.0 statistical package was used for analysis of the results. Quantitative variables were analyzed using parametric (Student t-test) or nonparametric tests (Mann–Whitney U-test), according to the results of the Kolmogorov–Smirnov test for the assessment of normal distributions. Qualitative variables in turn were analyzed using the chi-squared test, with the Fisher exact test (2-tailed) when the number of cases was under 5. Statistical significance was considered for p<0.05. Multivariate analysis was performed based on a logistic regression model to identify factors related to mortality in the NPPV group. We decided not to include the IMV group in the analysis, in order to avoid bias resulting from the inclusion of a group of patients who upon admission showed significant differences with respect to the NPPV group. The variables were included in the model using the enter method with a cutoff point of 0.1. The predictive capacity of the model was established from the Hosmer–Lemeshow test, the positive predictive value, the negative predictive value, diagnostic accuracy, and analysis of the area under the receiver operating characteristic (ROC) curve.ResultsDuring the study period, a total of 132 patients with hematological disease were admitted to the ICU, out of a total of 11,501 hospitalized patients. Of the mentioned 132 patients, 41 required ventilatory support (31%): NPPV in 35 cases (85%) and IMV in 6 (15%). The patient sample (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) consisted mainly of males (n=26; 63%), with a mean age of 56±6 years, a SOFA score of 7±3, and a SAPS 2 score of 63±18. Comparison of the two groups showed that upon admission, the IMV group had a greater incidence of organ failure as assessed by the SOFA (9±4 vs 7±2 in NPPV, p=0.025), and a poorer prognosis as determined by the SAPS 2 (66±17 vs 52±14 in NPPV, p=0.047). In contrast, the time to admission to the ICU was shorter in the NPPV group (3 [1–15] vs 26 [4–43] in IMV, p=0.033). Most of the patients came from hospital wards, where in some cases continuous positive airway pressure (CPAP) had been applied as a step prior to admission to the ICU. The most frequent comorbid condition in both groups was arterial hypertension, the predominant disease was acute leukemia, and the cause of ARF was pneumonia, without significant differences. The percentage of neutropenia was greater in the IMV group (83% vs 26% in NPPV, p=0.018). Comparison of the physiological parameters at baseline showed the IMV group to have more metabolic acidosis secondary to base excess (−9±7 vs −2±6 in NPPV, p=0.013), thrombopenia (14,500 [11,000–21,000] vs 96,000 [29,000–239,000] in NPPV, p=0.001), leukopenia (35 [20–100] vs 7210 [670–14,445] in NPPV, p=0.003), coagulopathy as determined by the Quick index (51 [21–65] vs 70 [52–81] in NPPV, p=0.05) and liver failure as estimated by bilirubin concentration (5 [3.12–5.00] vs 1 [0.79–1.55] in NPPV, p=0.022).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Regarding the clinical course (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>), there were no significant differences between IMV and NPPV regarding the percentage of infections, organ failure rate, duration of mechanical ventilation, or stay in the ICU and in hospital. The mortality rate both in the ICU and in hospital (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> and <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) was significantly higher in the IMV group (100% vs 37% in NPPV, p=0.006, in the ICU; and 100% vs 46% in NPPV, p=0.023, in hospital).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia>Within the NPPV group, on comparing success versus failure of the technique, no significant differences were observed in relation to the demographic characteristics, comorbidities or cause of respiratory failure (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Comparison of the physiological parameters showed differences between the success and failure of NPPV in terms of the level of PaO2 (82 [59–126] vs 58 [41–76], p<0.005), bicarbonate (24±6 vs 19±5, p<0.005), excess base deficit (0±6 vs −5±4, p<0.005), and blood hemoglobin (9±1 vs 10±2, p<0.005). The intubation rate was 40% (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>), which implies a greater organ dysfunction rate in this group, particularly as regards cardiovascular failure with the need for vasoactive support (100% vs 38% in the patients with successful NPPV, p=0.0001). There were no significant differences in infection rate, though a shorter duration of mechanical ventilation, a shorter stay in the ICU, and a lesser mortality rate both in the ICU and in hospital were recorded in the group of patients with successful NPPV. The mortality rate after 90 days was significantly lower (p=0.001) in the case of successful NPPV versus either failed NPPV or the IMV group (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).The multivariate analysis of all the variables significantly related to mortality in the NPPV group (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>) found the failure of NPPV (OR 13 [95% CI 1.95–89.22], p=0.008) and the development of ARDS (OR 10 [95% CI 1.33–77.9], p=0.03) to be related to mortality in the NPPV group. The positive predictive value of the model was 100%, with a negative predictive value of 59%, and a diagnostic accuracy of 74%. The area under the ROC curve was 0.88 (95% CI 0.773–0.993). The Hosmer–Lemeshow test with 4 degrees of freedom (d.f.) was not significant (p=0.525).<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>DiscussionOur retrospective study found hematological patients admitted to the ICU and subjected to mechanical ventilation due to ARF to have lesser mortality than in other series,<a class="elsevierStyleCrossRefs" href="#bib0015">3,5,7</a> and the use of NPPV constituted a key element in the supportive measures, since it influenced the decrease in mortality among such patients.Of note in our series is the use of NPPV as ventilatory support measure; in this sense, it is common practice in our Unit to make an attempt with this technique before considering IMV. Such practice has also been extended to the hospitalization ward, where a percentage of admitted patients receive ventilatory support with CPAP as a step prior to admission to the ICU. A randomized study<a class="elsevierStyleCrossRef" href="#bib0095">19</a> showed that the use of CPAP versus oxygen therapy in the Hematology ward in patients with ARF reduced progression toward ARDS, the need for admission to the ICU, and the need for invasive ventilatory support. Despite these results,<a class="elsevierStyleCrossRef" href="#bib0095">19</a> the application of CPAP in our small sample was greater in the group in which NPPV failed, and did not result in benefit of any kind. In our series, intubation from the start was limited to patients with multiorgan dysfunction as assessed by the SOFA score, which was higher than in the NPPV group–though not all the values reached statistical significance. This increased severity could account for the poor results obtained in the IMV group, since all the patients died in the ICU during the first hours, and mostly under conditions of multiorgan failure–this proportion being greater than expected from the SAPS 2 score. Different authors<a class="elsevierStyleCrossRefs" href="#bib0025">5,7</a> have underscored the predictive value of multiorgan failure in relation to mortality, though it should be taken into account that most patients upon admission, at least in our series, already presented dysfunction of several organs. In this sense, our data coincide with the findings of a Spanish multicenter study<a class="elsevierStyleCrossRef" href="#bib0100">20</a> that analyzed the ventilatory support measures in hematological patients, and in which the SOFA score was higher in those patients directly subjected to IMV versus the NPPV group, and the initial respiratory SOFA score was similar in the IMV and NPPV (success and failure) groups–though in the NPPV failure group the score worsened significantly with respect to the rest of the patients over time.In our opinion, NPPV has been a determinant factor in the reduction of mortality, since as we have seen, the number of complications and infections was not significantly greater in the IMV group (mainly due to the brief stay in the ICU caused by early mortality)–though all of them considered jointly, together with the organ dysfunction already present at the time of admission, probably influenced the final results obtained. These results therefore reaffirm our opinion that whenever possible, NPPV should be used for initial ventilatory support, in concordance with the observations of most studies published to date,<a class="elsevierStyleCrossRefs" href="#bib0010">2,20–22</a> in which utilization of the technique has been associated with a high level of evidence.<a class="elsevierStyleCrossRef" href="#bib0115">23</a> Nevertheless, recent studies<a class="elsevierStyleCrossRefs" href="#bib0025">5,20,22</a> continue to describe a greater use of IMV versus NPPV, though these same publications<a class="elsevierStyleCrossRefs" href="#bib0100">20,22</a> have shown NPPV to afford a substantial decrease in mortality compared with IMV. Another reason why our results are consistent with those obtained by other authors<a class="elsevierStyleCrossRefs" href="#bib0030">6,11–13,22,24</a> could be the close collaboration between the Department of Hematology and our Department of Intensive Care Medicine, thereby allowing earlier management of the many complications which these patients tend to present, and which are difficult to deal with in a hospitalization ward. The main element conditioning such close collaboration between our Departments was the introduction of NPPV in our range of therapeutic options. The high mortality associated with the need for IMV<a class="elsevierStyleCrossRefs" href="#bib0005">1,2,6</a> raised some doubts about admitting such patients to our Unit, in view of the important care burden involved (respiratory support, vasoactive and renal therapy in many cases, and the adoption of isolation measures), and the ominous outcomes. But the introduction of NPPV and the publication of studies<a class="elsevierStyleCrossRefs" href="#bib0030">6,11–13</a> warranting the use of this technique in immune depressed patients led to a substantial change in admission policy. Another consideration was the rapid development and severity of organ dysfunction in these patients, making it futile to admit such cases of established multiorgan failure to the ICU. Early intervention with early admission thus proved essential. In this same line, some studies<a class="elsevierStyleCrossRef" href="#bib0125">25</a> point to the benefits in terms of lessened mortality of admitting patients with hematological malignancies to the ICU based on a less restrictive admission policy. In this sense, consideration is also required of the fact that a delay in admission to the ICU is directly correlated to mortality–thus advocating early patient admission.<a class="elsevierStyleCrossRef" href="#bib0020">4</a>In this scenario favorable to NPPV, doubts remain as to why the technique is still underused. The reason could be the high incidence of ARDS upon admission or during patient stay in the ICU, and the controversial indication of NPPV in ARDS.<a class="elsevierStyleCrossRefs" href="#bib0050">10,26,27</a> Different studies<a class="elsevierStyleCrossRefs" href="#bib0140">28,29</a> have shown NPPV in hypoxemic patients to be more effective than oxygen therapy, with particular emphasis upon ALI or ARDS<a class="elsevierStyleCrossRefs" href="#bib0150">30–32</a>–registering an NPPV failure rate of between 4.8%<a class="elsevierStyleCrossRef" href="#bib0160">32</a> and 70% in ALI,<a class="elsevierStyleCrossRef" href="#bib0155">31</a> and between 46%<a class="elsevierStyleCrossRef" href="#bib0145">29</a> and 51% in patients with ARDS.<a class="elsevierStyleCrossRef" href="#bib0160">32</a> The multivariate analysis<a class="elsevierStyleCrossRefs" href="#bib0140">28,33</a> found the development of ARDS to be a predictor of NPPV failure–this possibly being the reason why there is no clear recommendation on the use of NPPV in the context of ARDS,<a class="elsevierStyleCrossRefs" href="#bib0045">9,10,25</a> and why the technique is little used in hematological patients with severe hypoxemia. In contrast, however, the relationship between IMV and mortality in this patient population has been well established.<a class="elsevierStyleCrossRefs" href="#bib0015">3,5,20–22</a> In this sense, a multicenter observational study<a class="elsevierStyleCrossRef" href="#bib0110">22</a> involving a series of 1302 hematological patients with ARF showed the use of NPPV to be less widespread than that of IMV (21% vs 79%). The noninvasive group presented more neutropenia (16.8% vs 10%, p<0.002) and hypoxemia than the invasive ventilation group. In contrast, the patients in the IMV group were in more serious condition as established by the APACHE score, and had a poorer level of consciousness. This may have justified the initial use of IMV. A significant difference was also noted in the use of NPPV versus IMV in patients with ALI (21% vs 11%, p=0.0001). In the case of patients with ARDS, the difference failed to reach statistical significance. The results showed the NPPV group to have a shorter duration of mechanical ventilation and stay in the ICU, as well as lesser mortality both in the ICU and in hospital, but these results were not reproduced in the subgroup of patients with ALI or ARDS. Another observational study<a class="elsevierStyleCrossRef" href="#bib0030">6</a> found mortality after 30 days in the NPPV group to be significantly lower than in the IMV group (43.7% vs 70.8%, p=0.008).On analyzing the NPPV group, failure of the technique was seen to be associated with a greater complications rate. These results coincide with those obtained in other studies,<a class="elsevierStyleCrossRefs" href="#bib0100">20,22,24,30</a> where the failure of NPPV markedly increased the percentage of complications, the duration of stay, and mortality. In coincidence with other authors,<a class="elsevierStyleCrossRefs" href="#bib0100">20,22,27,28</a> we found mortality to be associated with failure of NPPV and development of ARDS, along with other variables<a class="elsevierStyleCrossRefs" href="#bib0100">20,22</a> such as age, septic shock, coma, coagulation disorders or a high SAPS 2 score, which were not analyzed in our series. Given the strong negative influence of NPPV failure upon mortality, it seems logical to explore the factors that influence such failure. In this context, different studies<a class="elsevierStyleCrossRefs" href="#bib0120">24,28</a> have identified delayed introduction of ventilatory support, the development of ARDS, and the need for vasoactive and renal support as predictors of NPPV failure. Another cohort study of patients with ARDS<a class="elsevierStyleCrossRef" href="#bib0150">30</a> found severity as determined by a SAPS 2 score of >34, and the absence of improvement in oxygenation (PaO2/FiO2<175) 60min after starting NPPV, to be predictors of failure. From the above it can be concluded that NPPV will probably fail if the start of the technique is delayed in a hypoxemic patient with scant clinical and blood gas response after 1h–intubation being required in such cases.The limitations of our study are represented by its retrospective nature, and the fact that it was carried out in a single center where NPPV moreover is routine practice in patients with hypoxemic ARF.Despite the poor results obtained in the IMV group, we do not intend to discard the use of the technique. Rather, we wish to underscore the benefits of NPPV in extremely ill patients, with a poor prognosis and with multiple organ dysfunction. The routine use of NPPV, and the risk of intubation particularly in these patients, implies that the few individuals directly included in the IMV group were in a condition in which NPPV was literally contraindicated. The conduction of a prospective study comparing NPPV versus IMV with a literature basis<a class="elsevierStyleCrossRefs" href="#bib0015">3,5,7</a> demonstrating the mortality associated to IMV, along with studies<a class="elsevierStyleCrossRefs" href="#bib0030">6,22</a> showing the good results obtained with NPPV, therefore would be very questionable. Consequently, on the basis of our results, we could recommend the use of NPPV as a first ventilatory support measure in hematological patients with ARF, without considering the classical NPPV indication criteria,<a class="elsevierStyleCrossRefs" href="#bib0050">10,26,27</a> and without regarding ARDS or multiorgan dysfunction as exclusion criteria–since at the time of admission to the ICU, most of these patients already suffer dysfunction of one or more organ systems.Conflicts of interestThe authors declare that they have no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:2 [ "identificador" => "xres295682" "titulo" => array:8 [ 0 => "Abstract" 1 => "Objective" 2 => "Design" 3 => "Setting" 4 => "Patients" 5 => "Variables of interest" 6 => "Results" 7 => "Conclusion" ] ] 1 => array:2 [ "identificador" => "xpalclavsec279511" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres295681" "titulo" => array:8 [ 0 => "Resumen" 1 => "Objetivo" 2 => "Diseño" 3 => "Ámbito" 4 => "Pacientes" 5 => "Variables de interés" 6 => "Resultados" 7 => "Conclusión" ] ] 3 => array:2 [ "identificador" => "xpalclavsec279512" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Monitorization and study variables" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Noninvasive ventilatory support" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Invasive ventilatory support" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0040" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflicts of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-08-27" "fechaAceptado" => "2012-12-21" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec279511" "palabras" => array:5 [ 0 => "Hematological malignancy" 1 => "Noninvasive positive pressure ventilation" 2 => "Pneumonia" 3 => "Invasive mechanical ventilation" 4 => "Acute respiratory failure" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec279512" "palabras" => array:5 [ 0 => "Enfermedad hematológica" 1 => "Ventilación mecánica no invasiva" 2 => "Neumonía" 3 => "Ventilación mecánica invasiva" 4 => "Insuficiencia respiratoria aguda" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "ObjectiveA comparison was made between invasive mechanical ventilation (IMV) and noninvasive positive pressure ventilation (NPPV) in hematological patients with acute respiratory failure. DesignA retrospective observational study was made from 2001 to December 2011. SettingA clinical–surgical intensive care unit (ICU) in a tertiary hospital. PatientsPatients with hematological malignancies suffering acute respiratory failure (ARF) and requiring mechanical ventilation in the form of either IMV or NPPV. Variables of interestAnalysis of infection and organ failure rates, duration of mechanical ventilation and ICU and hospital stays, as well as ICU, hospital and mortality after 90 days. The same variables were analyzed in the comparison between NPPV success and failure. ResultsForty-one patients were included, of which 35 required IMV and 6 NPPV. ICU mortality was higher in the IMV group (100% vs 37% in NPPV, p=.006). The intubation rate in NPPV was 40%. Compared with successful NPPV, failure in the NPPV group involved more complications, a longer duration of mechanical ventilation and ICU stay, and greater ICU and hospital mortality. Multivariate analysis of mortality in the NPPV group identified NPPV failure (OR 13 [95% CI 1.33–77.96], p=.008) and progression to acute respiratory distress syndrome (OR 10 [95% CI 1.95–89.22], p=.03) as prognostic factors. ConclusionThe use of NPPV reduced mortality compared with IMV. NPPV failure was associated with more complications." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "ObjetivoComparación de la ventilación mecánica invasiva (VMI) frente a la no invasiva (VMNI) en pacientes hematológicos que desarrollaron insuficiencia respiratoria aguda (IRA). DiseñoEstudio observacional retrospectivo desde 2001 y hasta diciembre de 2011. ÁmbitoUnidad de cuidados intensivos (UCI) médico-quirúrgica de un hospital de tercer nivel. PacientesAquellos con patología hematológica con IRA y que precisaron ventilación mecánica (VM), tanto VMI como VMNI. Variables de interésNúmero de infeccciones y fracaso de órganos, duración de VM y estancias en la unidad y hospitalaria, así como mortalidad en UCI, hospitalaria y a los 90 días. En el subgrupo de VMNI se comparó éxito y fracaso en cuanto a las variables mencionadas. ResultadosSe incluyeron 41 pacientes que precisaron VM, 35 con VMNI y 6 con VMI. La mortalidad en UCI fue superior en VMI (100 vs 37% en VMNI, p=0,006). El porcentaje de intubación en VMNI fue del 40%. El grupo fracaso de VMNI presentó mayor tasa de complicaciones, mayor duración de la VM, mayor estancia en UCI, así como de mortalidad en UCI y hospitalaria que el grupo que no precisó intubación. El análisis multivariante de mortalidad en el grupo VMNI estaba relacionada con el fracaso de la VMNI (OR 13 [IC 95% 1,33–77,96], p=0,008) y el desarrollo de síndrome de distrés respiratorio del adulto (OR 10 [IC 95% 1,95–89,22], p=0,03). ConclusiónLa utilización de VMNI redujo la mortalidad en comparación con la VMI. El fracaso de la VMNI llevó aparejada una mayor tasa de complicaciones." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Belenguer-Muncharaz A, Albert-Rodrigo L, Ferrandiz-Sellés A, Cebrián-Graullera G. Evolución de 10 años de aplicación de la ventilación mecánica en la insuficiencia respiratoria aguda del paciente hematológico ingresado en la unidad de cuidados intensivos. Med Intensiva. 2013;37:452–460." ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2106 "Ancho" => 2918 "Tamanyo" => 200270 ] ] "descripcion" => array:1 [ "en" => "Kaplan–Meier survival analysis (log-rank test) between the NPPV group (success and failure) and the IMV group after 90 days. Table: number of patients alive during this period of time. IMV, invasive mechanical ventilation; NPPV, noninvasive positive pressure ventilation; NPPV OTI, intubated noninvasive ventilation; NPPV-NO OTI, non-intubated noninvasive ventilation." ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "CPAP, continuous positive airway pressure; COPD, chronic obstructive pulmonary disease; ARF, acute respiratory failure; SAPS 2, Simplified Acute Physiology Score (range 0–56); SOFA, Sequential Organ Failure Assessment; TRALI, transfusion-related acute lung injury; ICU, Intensive Care Unit; IMV, invasive mechanical ventilation; NPPV, noninvasive positive pressure ventilation." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Global(n=41) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">NPPV(n=35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">NPPV success (n=21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">NPPV failure(n=14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">IMV<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a>(n=6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0045">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sex, male (n=26), n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (63) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (63) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (67) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a>, years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56±6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58±14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">59±12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57±20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50±12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.280 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SOFA<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7±3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7±2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7±2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7±3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9±4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.025 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SAPS 2<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">63±18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52±14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53±17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50±11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66±17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.047 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SAPS 2 (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">54±26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49±25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">51±28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48±20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">73±29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.054 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Time to admission to UCI<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (1–15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (1–15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (1–15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (1–16) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (4–43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.033 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CPAP prior to admission, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.622 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Origin of patients, n (%)</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Clinical or surgical ward \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 (80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 (80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (78) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Emergencies \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Operating room \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other ICU \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Comorbidities, n (%)</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Arterial hypertension \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (41) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (46) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (57) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.382 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">COPD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.567 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Congestive heart failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diabetes mellitus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Previous cancer<a class="elsevierStyleCrossRef" href="#tblfn0020">d</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.483 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Smoking \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1(7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.683 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chronic renal failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.146 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Neutropenia, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (34) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (26) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.013 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Type of hematological disease</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.608 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Acute leukemia, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (44) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-Hodgkin lymphoma, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (26) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Multiple myeloma, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Others<a class="elsevierStyleCrossRef" href="#tblfn0025">e</a>, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cause of acute respiratory failure, n (%)</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pneumonia<a class="elsevierStyleCrossRef" href="#tblfn0030">f</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (39) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sepsis<a class="elsevierStyleCrossRef" href="#tblfn0035">g</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (39) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (66) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ARF of pulmonary origin<a class="elsevierStyleCrossRef" href="#tblfn0040">h</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (7.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Acute lung edema \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (3.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Postoperative ARF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (3.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (7.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TRALI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab431142.png" ] ] ] "notaPie" => array:9 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Mean±SD; the rest as percentage." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "Median and 25–75% interquartile range; the rest as percentage." ] 2 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "c" "nota" => "Causes of intubation: urgent surgery (2 cases), urgent intubation in ward due to respiratory fatigue (2 cases), severe hypoxemia (1 case) and diminished consciousness (1 case)." ] 3 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "d" "nota" => "Causes of cancer: NPPV (prostate, ear, nose and throat, gastrointestinal), IMV (gynecological)." ] 4 => array:3 [ "identificador" => "tblfn0025" "etiqueta" => "e" "nota" => "Bone marrow aplasia (1 case), hyaline-vascular type Castleman's disease (1 case), chronic leukemia (2 cases), Hodgkin's disease (2 cases)." ] 5 => array:3 [ "identificador" => "tblfn0030" "etiqueta" => "f" "nota" => "Cause of pneumonia: pneumococcus (3 cases), H1N1 influenza (1 case), rest unknown." ] 6 => array:3 [ "identificador" => "tblfn0035" "etiqueta" => "g" "nota" => "Causes of sepsis: bacteremia (5 cases in NPPV and 1 case in IMV), unknown focus (4 cases in NPPV), urological (1 case in NPPV), infections from blood products (1 case in NPPV), soft tissues (2 cases in IMV), ear, nose and throat (1 case in IMV), abdominal (1 case in NPPV)." ] 7 => array:3 [ "identificador" => "tblfn0040" "etiqueta" => "h" "nota" => "Causes of pulmonary ARF: adult respiratory distress syndrome (4 cases), pleural effusion (1 case), possible pulmonary hemorrhage (1 case)." ] 8 => array:3 [ "identificador" => "tblfn0045" "etiqueta" => "*" "nota" => "Comparison NPPV vs IMV." ] ] ] "descripcion" => array:1 [ "en" => "Demographic characteristics, comorbidities and cause of acute respiratory failure." ] ] 2 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "ARDS, adult respiratory distress syndrome; ICU, Intensive Care Unit; IMV, invasive mechanical ventilation; NPPV, noninvasive positive pressure ventilation; VAP, ventilator associated pneumonia." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">NPPV (n=35)</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">p<a class="elsevierStyleCrossRef" href="#tblfn0055">**</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">IMV (n=6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">p<a class="elsevierStyleCrossRef" href="#tblfn0050">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">GlobalNPPV(n=35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">SuccessNPPV(n=21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">FailureNPPV(n=14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">VAP, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.153 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Urinary infection, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.551 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.483 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bacteremia, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.724 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.662 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Primary bacteremia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Catheter-related bacteremia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Secondary bacteremia<a class="elsevierStyleCrossRef" href="#tblfn0060">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Organ failure, n (%)</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cardiovascular \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (63) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.152 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hematological \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (57) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (64) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.737 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.388 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ARDS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (51) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (71) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.086 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (67) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.688 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Renal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (57) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.075 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.070 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hepatic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.221 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.316 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Neurological \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.169 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cardiac arrest, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.056 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.148 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Barotrauma, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.153 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Tracheostomy, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.153 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Duration mechanical ventilation<a class="elsevierStyleCrossRef" href="#tblfn0065">b</a>, days \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8±9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4±3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13±12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.016 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3±6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.269 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stay in ICU<a class="elsevierStyleCrossRef" href="#tblfn0065">b</a>, days \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11±11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7±4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18±15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.025 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5±10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.190 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stay in hospital<a class="elsevierStyleCrossRef" href="#tblfn0065">b</a>, days \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34±19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33±19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32±21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.800 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26±26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.554 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mortality in ICU, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (71) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.006 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Causes of death \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Multiorgan failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cardiac arrest \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cerebral hemorrhage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Refractory hypoxemia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mortality in hospital, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (46) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (71) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.018 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.023 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab431141.png" ] ] ] "notaPie" => array:4 [ 0 => array:3 [ "identificador" => "tblfn0050" "etiqueta" => "*" "nota" => "Comparison of NPPV vs IMV." ] 1 => array:3 [ "identificador" => "tblfn0055" "etiqueta" => "**" "nota" => "Comparison of success vs failure of NPPV." ] 2 => array:3 [ "identificador" => "tblfn0060" "etiqueta" => "a" "nota" => "Secondary bacteremia foci: pulmonary (2 cases), urinary (3 cases), abdominal (1 case) and blood product bag infection by Klebsiella oxytoca (1 case)." ] 3 => array:3 [ "identificador" => "tblfn0065" "etiqueta" => "b" "nota" => "Represented as mean±SD; the rest as percentage." ] ] ] "descripcion" => array:1 [ "en" => "Comparison of complication rates, duration of ventilation and duration of stay between NPPV (both success and failure) and IMV." ] ] 3 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "95% CI, 95% confidence interval; CRA, cardiorespiratory arrest; ARDS, adult respiratory distress syndrome; NPPV, noninvasive positive pressure ventilation." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">NPPV survivors (n=22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">NPPV non-survivors (n=13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Odds ratio \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Basal metabolic acidosis, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (46) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.236 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Failure NPPV, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (18) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (77) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.33 – 77.96 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.008 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hemodynamic failure, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (84) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Liver failure, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (46) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.032 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ARDS, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (32) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (85) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.005 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.95 – 89.22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.025 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CRA, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.04 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab431140.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Multivariate analysis of factors related to mortality in the NPPV group." ] ] ] "bibliografia" => 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Ten-year evolution of mechanical ventilation in acute respiratory failure in the hematogical patient admitted to the intensive care unit

Evolución de 10 años de aplicación de la ventilación mecánica en la insuficiencia respiratoria aguda del paciente hematológico ingresado en la unidad de cuidados intensivos

A. Belenguer-Muncharaz

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belenguer_alb@gva.es

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, L. Albert-Rodrigo, A. Ferrandiz-Sellés, G. Cebrián-Graullera

Servicio de Medicina Intensiva, Hospital General de Castellón, Castellón de la Plana, Spain

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          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Kaplan&#8211;Meier survival analysis &#40;log-rank test&#41; between the NPPV group &#40;success and failure&#41; and the IMV group after 90 days&#46; Table&#58; number of patients alive during this period of time&#46; IMV&#44; invasive mechanical ventilation&#59; NPPV&#44; noninvasive positive pressure ventilation&#59; NPPV OTI&#44; intubated noninvasive ventilation&#59; NPPV-NO OTI&#44; non-intubated noninvasive ventilation&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The prognosis of malignant hematological disease has improved over the last few decades&#44;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> though patients requiring admission to the intensive care unit &#40;ICU&#41; continue to present a high mortality rate&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;5</span></a> The main cause of admission to the ICU is the development of acute respiratory failure &#40;ARF&#41;&#44; sometimes requiring ventilatory support&#44;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;7</span></a> due to the appearance of both infectious and non-infectious pulmonary infiltrates&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> On the other hand&#44; mechanical ventilation &#40;MV&#41;&#44; and particularly invasive mechanical ventilation &#40;IMV&#41;&#44; has been shown to be one of the risk factors of mortality in the ICU&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The development of noninvasive positive pressure ventilation &#40;NPPV&#41; as a ventilatory support technique has represented a great step forward in the ventilatory care of critically ill patients&#46; NPPV offers a series of benefits&#44;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10</span></a> since it lessens the need for orotracheal intubation thanks to resting of the muscle burden generated by the respiratory disease underlying ARF&#59; improves oxygenation&#59; and facilitates the elimination of carbon dioxide&#46; As a direct consequence of this&#44; NPPV is able to reduce the incidence of ventilator associated pneumonia &#40;VAP&#41; and shorten patient stay in the ICU and in hospital&#44; especially in immune depressed individuals&#46; Nevertheless&#44; despite these reported benefits and the existence of studies supporting the success of the technique&#44;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;10&#8211;13</span></a> NPPV is still less widely used than expected&#44; and IMV remains the gold standard for the ventilation support of these patients&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The present study analyzes the incidence of ARF in hematological patients admitted to the ICU and requiring mechanical ventilation &#40;invasive and noninvasive&#41;&#44; with the purpose of determining whether NPPV is superior to IMV in terms of the development of infections&#44; organ failure&#44; the duration of mechanical ventilation&#44; the duration of stay in the ICU and in hospital&#44; and mortality in the ICU&#44; in hospital&#44; and after 90 days&#46; Likewise&#44; an analysis was made of the incidence of NPPV failure&#44; comparing the same variables between the success and failure groups&#44; and of the factors related to mortality in the NPPV group&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Materials and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">A retrospective observational was carried out&#44; following approval by the hospital Clinical Research Ethics Committee&#46; We included all hematological patients with ARF admitted to the ICU between January 2001 and December 2011&#44; and who required ventilatory support&#46; The hematological diseases mainly comprised acute leukemia &#40;lymphoblastic or myelocytic&#41;&#44; non-Hodgkin lymphoma&#44; multiple myeloma&#44; chronic leukemia and Hodgkin&#39;s disease&#46; The patients had received chemotherapy&#44; corticosteroid therapy or treatment in the form of hematopoietic precursor cell transplantation&#46; Neutropenia was defined as a leukocyte count of under 1000<span class="elsevierStyleHsp" style=""></span>cells&#47;mm<span class="elsevierStyleSup">3</span>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Acute respiratory failure was defined as a respiratory frequency &#40;RF&#41; of &#62;30<span class="elsevierStyleHsp" style=""></span>rpm&#44; a partial oxygen pressure &#40;PaO<span class="elsevierStyleInf">2</span>&#41; of &#60;60<span class="elsevierStyleHsp" style=""></span>mmHg or a partial carbon dioxide pressure &#40;PaCO<span class="elsevierStyleInf">2</span>&#41; of &#62;45<span class="elsevierStyleHsp" style=""></span>mmHg&#46; Community-acquired pneumonia &#40;CAP&#41; was considered as a lower airway infection characterized by opacifications on the chest X-rays&#44; signs and symptoms of respiratory infection such as fever&#44; cough&#44; pleuritic pain&#44; leukocytosis or leukopenia&#44; and the presence or absence of secretions&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> Hypoxemic conditions were classified as acute lung injury &#40;ALI&#41; or adult respiratory distress syndrome &#40;ARDS&#41;&#44; based on the following criteria<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&#58; bilateral infiltration&#44; pulmonary wedge pressure<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>18<span class="elsevierStyleHsp" style=""></span>mmHg&#44; PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>300 &#40;ALI&#41; or PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>200 &#40;ARDS&#41;&#46; For the microbiological study we determined soluble antigens in urine&#44; and peripheral blood samples were obtained for blood culture and pneumonia serological testing&#46; Lastly&#44; where possible&#44; we obtained sputum for culture and gram staining&#46; Nasopharyngeal aspiration in turn was performed for determination of the new H1N1 influenza virus &#8211; this test being carried out on a routine basis since 2009 in all cases of pneumonia exhibiting an interstitial radiological pattern&#46; Non-bronchoscopic invasive samples &#40;bronchoalveolar lavage and bronchial aspirate&#41;&#44; were collected once the patients were intubated&#46; The criteria for sepsis and septic shock were established according to the literature&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Monitorization and study variables</span><p id="par0030" class="elsevierStylePara elsevierViewall">Upon patient admission&#44; invasive hemodynamic monitorization was carried out&#44; with arterial catheterization and a central venous line&#46; Respiratory monitorization in turn was carried out by recording transcutaneous oxygen saturation &#40;SatcO<span class="elsevierStyleInf">2</span>&#41; with an Oxisensor Nellcor <span class="elsevierStyleSmallCaps">II</span> D-25 pulsioxymeter &#40;Nellcor<span class="elsevierStyleSup">&#174;</span> Puritan Bennet Inc&#46;&#44; Decasanton&#44; CA&#44; USA&#41;&#44; and arterial blood samples were obtained for blood gas determinations using an ABL560 cooxymeter &#40;Radiometer Medical A&#47;S<span class="elsevierStyleSup">&#174;</span>&#44; Copenhagen&#44; Denmark&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Upon patient admission and during the stay in the ICU&#44; we collected personal data and information referred to the diagnosis&#44; severity based on the Simplified Acute Physiology Score &#40;SAPS&#41; 2 and organ failure based on the Sequential Organ Failure Assessment &#40;SOFA&#41;&#46; We also recorded the corresponding hemodynamic&#44; respiratory&#44; blood gas and biochemical variables&#46; The duration of stay in the ICU and in hospital was registered&#44; along with the duration of mechanical ventilation&#46; In turn&#44; the complications occurring during stay in the Unit were documented&#44; such as orotracheal intubation&#44; barotrauma&#44; nosocomial infections&#44; the need for tracheotomy and mortality &#40;in the ICU&#44; in hospital&#44; and 90 days after admission&#41;&#46; The organ dysfunction rate was assessed based on the Marshall scale&#44;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> which contemplates acute renal failure &#40;with or without hemofiltration&#41; and cardiovascular&#44; hematological&#44; neurological and hepatic failure&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Noninvasive ventilatory support</span><p id="par0040" class="elsevierStylePara elsevierViewall">Use was made of the BiPAP Vision respirator<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> &#40;Respironics Inc&#46;<span class="elsevierStyleSup">&#174;</span>&#44; PA&#44; USA&#41; connected to an orofacial or Total face<span class="elsevierStyleSup"><span class="elsevierStyleItalic">&#174;</span></span> mask &#40;Respironics Inc&#46;<span class="elsevierStyleSup">&#174;</span>&#44; PA&#44; USA&#41; with an MR850 active humidification system &#40;Fischer and Payckel Healthcare Ltd&#46;&#44; New Zealand&#41;&#46; After explaining the technique to the patient&#44; the mask was fitted and we progressively increased the positive end-expiratory pressure &#40;PEEP&#41; and the support pressure to above the PEEP &#40;SP&#41;&#44; until achieving a tidal volume &#40;Vt&#41; of 10&#8211;15<span class="elsevierStyleHsp" style=""></span>ml&#47;kg and a RF of 25&#8211;28<span class="elsevierStyleHsp" style=""></span>rpm&#44; thereby ensuring a minimum SP of 10&#8211;15<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O and a PEEP of 5&#8211;6<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O in the first hour of ventilatory support&#46; The oxygen concentration was adjusted until reaching SatcO<span class="elsevierStyleInf">2</span> &#62;94&#37;&#46; Once the clinical and&#47;or blood gas condition of the patient improved&#44; gradual ventilator withdrawal was carried out until complete disconnection of NPPV&#46; The changes in FiO<span class="elsevierStyleInf">2</span> and SP&#47;PEEP levels were made according to the criterion of the supervising physician&#46; NPPV failure was considered in the presence of any of the following criteria<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#58; persistence of respiratory effort or hypoxemia&#44; cognitive impairment&#44; or asynchrony with the respirator&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Invasive ventilatory support</span><p id="par0045" class="elsevierStylePara elsevierViewall">Patient sedation was carried out with midazolam or propofol associated to morphine&#44; followed by orotracheal intubation and connection to the respirator&#46; Initial parameters&#58; volume control&#47;assist ventilation &#40;CMV&#47;a&#41;&#44; Vt&#58; 6&#8211;8<span class="elsevierStyleHsp" style=""></span>ml&#47;kg&#44; flow 60<span class="elsevierStyleHsp" style=""></span>l&#47;min&#44; RF&#58; 12&#8211;14<span class="elsevierStyleHsp" style=""></span>rpm&#44; FiO<span class="elsevierStyleInf">2</span> to achieve SatcO<span class="elsevierStyleInf">2</span> 94&#8211;96&#37;&#44; and minimum PEEP 5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#46; Progression of the respiratory process to ARDS required modification of the ventilatory parameters<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a>&#58; Vt<span class="elsevierStyleHsp" style=""></span>&#60;6<span class="elsevierStyleHsp" style=""></span>ml&#47;kg&#44; plateau pressure<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>35<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#44; progressive PEEP and FiO<span class="elsevierStyleInf">2</span> as low as possible with the aim of achieving SactO<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>94&#37;&#46; After recovery&#44; weaning was started&#44; followed by extubation with the spontaneous breathing test&#46; The modifications of the ventilatory parameters and weaning were carried out by the supervising physician&#46; The patient was considered to have passed the breathing test if there was no hemodynamic or respiratory worsening during 2<span class="elsevierStyleHsp" style=""></span>h&#46; In such cases extubation was considered indicated&#44; always conditioned to medical criterion&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The duration of mechanical ventilation included the time &#40;in days&#41; of mechanical ventilation and the weaning time&#46; Hospital stay in turn was documented as the total stay of the patient in the ICU and in hospital&#46; The application of IMV or NPPV&#44; along with the rest of supportive measures &#40;vasoactive drugs&#44; antibiotherapy&#44; renal replacement therapy&#44; blood product transfusion&#44; nutritional support&#41;&#44; was regarded as the responsibility of the attending physician at the time of admission&#44; in collaboration with the Department of Hematology&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Given the characteristics of the study&#44; informed consent from the patient and&#47;or family was not considered necessary&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Statistical analysis</span><p id="par0060" class="elsevierStylePara elsevierViewall">The SPSS version 18&#46;0 statistical package was used for analysis of the results&#46; Quantitative variables were analyzed using parametric &#40;Student <span class="elsevierStyleItalic">t</span>-test&#41; or nonparametric tests &#40;Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span>-test&#41;&#44; according to the results of the Kolmogorov&#8211;Smirnov test for the assessment of normal distributions&#46; Qualitative variables in turn were analyzed using the chi-squared test&#44; with the Fisher exact test &#40;2-tailed&#41; when the number of cases was under 5&#46; Statistical significance was considered for <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; Multivariate analysis was performed based on a logistic regression model to identify factors related to mortality in the NPPV group&#46; We decided not to include the IMV group in the analysis&#44; in order to avoid bias resulting from the inclusion of a group of patients who upon admission showed significant differences with respect to the NPPV group&#46; The variables were included in the model using the enter method with a cutoff point of 0&#46;1&#46; The predictive capacity of the model was established from the Hosmer&#8211;Lemeshow test&#44; the positive predictive value&#44; the negative predictive value&#44; diagnostic accuracy&#44; and analysis of the area under the receiver operating characteristic &#40;ROC&#41; curve&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">During the study period&#44; a total of 132 patients with hematological disease were admitted to the ICU&#44; out of a total of 11&#44;501 hospitalized patients&#46; Of the mentioned 132 patients&#44; 41 required ventilatory support &#40;31&#37;&#41;&#58; NPPV in 35 cases &#40;85&#37;&#41; and IMV in 6 &#40;15&#37;&#41;&#46; The patient sample &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; consisted mainly of males &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>26&#59; 63&#37;&#41;&#44; with a mean age of 56<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6 years&#44; a SOFA score of 7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; and a SAPS 2 score of 63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>18&#46; Comparison of the two groups showed that upon admission&#44; the IMV group had a greater incidence of organ failure as assessed by the SOFA &#40;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4 vs 7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2 in NPPV&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;025&#41;&#44; and a poorer prognosis as determined by the SAPS 2 &#40;66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17 vs 52<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14 in NPPV&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;047&#41;&#46; In contrast&#44; the time to admission to the ICU was shorter in the NPPV group &#40;3 &#91;1&#8211;15&#93; vs 26 &#91;4&#8211;43&#93; in IMV&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;033&#41;&#46; Most of the patients came from hospital wards&#44; where in some cases continuous positive airway pressure &#40;CPAP&#41; had been applied as a step prior to admission to the ICU&#46; The most frequent comorbid condition in both groups was arterial hypertension&#44; the predominant disease was acute leukemia&#44; and the cause of ARF was pneumonia&#44; without significant differences&#46; The percentage of neutropenia was greater in the IMV group &#40;83&#37; vs 26&#37; in NPPV&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;018&#41;&#46; Comparison of the physiological parameters at baseline showed the IMV group to have more metabolic acidosis secondary to base excess &#40;&#8722;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7 vs &#8722;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6 in NPPV&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;013&#41;&#44; thrombopenia &#40;14&#44;500 &#91;11&#44;000&#8211;21&#44;000&#93; vs 96&#44;000 &#91;29&#44;000&#8211;239&#44;000&#93; in NPPV&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; leukopenia &#40;35 &#91;20&#8211;100&#93; vs 7210 &#91;670&#8211;14&#44;445&#93; in NPPV&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41;&#44; coagulopathy as determined by the Quick index &#40;51 &#91;21&#8211;65&#93; vs 70 &#91;52&#8211;81&#93; in NPPV&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; and liver failure as estimated by bilirubin concentration &#40;5 &#91;3&#46;12&#8211;5&#46;00&#93; vs 1 &#91;0&#46;79&#8211;1&#46;55&#93; in NPPV&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;022&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Regarding the clinical course &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#44; there were no significant differences between IMV and NPPV regarding the percentage of infections&#44; organ failure rate&#44; duration of mechanical ventilation&#44; or stay in the ICU and in hospital&#46; The mortality rate both in the ICU and in hospital &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> and <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41; was significantly higher in the IMV group &#40;100&#37; vs 37&#37; in NPPV&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;006&#44; in the ICU&#59; and 100&#37; vs 46&#37; in NPPV&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;023&#44; in hospital&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Within the NPPV group&#44; on comparing success versus failure of the technique&#44; no significant differences were observed in relation to the demographic characteristics&#44; comorbidities or cause of respiratory failure &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Comparison of the physiological parameters showed differences between the success and failure of NPPV in terms of the level of PaO<span class="elsevierStyleInf">2</span> &#40;82 &#91;59&#8211;126&#93; vs 58 &#91;41&#8211;76&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41;&#44; bicarbonate &#40;24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6 vs 19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41;&#44; excess base deficit &#40;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6 vs &#8722;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41;&#44; and blood hemoglobin &#40;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1 vs 10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41;&#46; The intubation rate was 40&#37; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#44; which implies a greater organ dysfunction rate in this group&#44; particularly as regards cardiovascular failure with the need for vasoactive support &#40;100&#37; vs 38&#37; in the patients with successful NPPV&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#46; There were no significant differences in infection rate&#44; though a shorter duration of mechanical ventilation&#44; a shorter stay in the ICU&#44; and a lesser mortality rate both in the ICU and in hospital were recorded in the group of patients with successful NPPV&#46; The mortality rate after 90 days was significantly lower &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; in the case of successful NPPV versus either failed NPPV or the IMV group &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The multivariate analysis of all the variables significantly related to mortality in the NPPV group &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41; found the failure of NPPV &#40;OR 13 &#91;95&#37; CI 1&#46;95&#8211;89&#46;22&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41; and the development of ARDS &#40;OR 10 &#91;95&#37; CI 1&#46;33&#8211;77&#46;9&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41; to be related to mortality in the NPPV group&#46; The positive predictive value of the model was 100&#37;&#44; with a negative predictive value of 59&#37;&#44; and a diagnostic accuracy of 74&#37;&#46; The area under the ROC curve was 0&#46;88 &#40;95&#37; CI 0&#46;773&#8211;0&#46;993&#41;&#46; The Hosmer&#8211;Lemeshow test with 4 degrees of freedom &#40;d&#46;f&#46;&#41; was not significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;525&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">Our retrospective study found hematological patients admitted to the ICU and subjected to mechanical ventilation due to ARF to have lesser mortality than in other series&#44;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;5&#44;7</span></a> and the use of NPPV constituted a key element in the supportive measures&#44; since it influenced the decrease in mortality among such patients&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Of note in our series is the use of NPPV as ventilatory support measure&#59; in this sense&#44; it is common practice in our Unit to make an attempt with this technique before considering IMV&#46; Such practice has also been extended to the hospitalization ward&#44; where a percentage of admitted patients receive ventilatory support with CPAP as a step prior to admission to the ICU&#46; A randomized study<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> showed that the use of CPAP versus oxygen therapy in the Hematology ward in patients with ARF reduced progression toward ARDS&#44; the need for admission to the ICU&#44; and the need for invasive ventilatory support&#46; Despite these results&#44;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> the application of CPAP in our small sample was greater in the group in which NPPV failed&#44; and did not result in benefit of any kind&#46; In our series&#44; intubation from the start was limited to patients with multiorgan dysfunction as assessed by the SOFA score&#44; which was higher than in the NPPV group&#8211;though not all the values reached statistical significance&#46; This increased severity could account for the poor results obtained in the IMV group&#44; since all the patients died in the ICU during the first hours&#44; and mostly under conditions of multiorgan failure&#8211;this proportion being greater than expected from the SAPS 2 score&#46; Different authors<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;7</span></a> have underscored the predictive value of multiorgan failure in relation to mortality&#44; though it should be taken into account that most patients upon admission&#44; at least in our series&#44; already presented dysfunction of several organs&#46; In this sense&#44; our data coincide with the findings of a Spanish multicenter study<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> that analyzed the ventilatory support measures in hematological patients&#44; and in which the SOFA score was higher in those patients directly subjected to IMV versus the NPPV group&#44; and the initial respiratory SOFA score was similar in the IMV and NPPV &#40;success and failure&#41; groups&#8211;though in the NPPV failure group the score worsened significantly with respect to the rest of the patients over time&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">In our opinion&#44; NPPV has been a determinant factor in the reduction of mortality&#44; since as we have seen&#44; the number of complications and infections was not significantly greater in the IMV group &#40;mainly due to the brief stay in the ICU caused by early mortality&#41;&#8211;though all of them considered jointly&#44; together with the organ dysfunction already present at the time of admission&#44; probably influenced the final results obtained&#46; These results therefore reaffirm our opinion that whenever possible&#44; NPPV should be used for initial ventilatory support&#44; in concordance with the observations of most studies published to date&#44;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;20&#8211;22</span></a> in which utilization of the technique has been associated with a high level of evidence&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> Nevertheless&#44; recent studies<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;20&#44;22</span></a> continue to describe a greater use of IMV versus NPPV&#44; though these same publications<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;22</span></a> have shown NPPV to afford a substantial decrease in mortality compared with IMV&#46; Another reason why our results are consistent with those obtained by other authors<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;11&#8211;13&#44;22&#44;24</span></a> could be the close collaboration between the Department of Hematology and our Department of Intensive Care Medicine&#44; thereby allowing earlier management of the many complications which these patients tend to present&#44; and which are difficult to deal with in a hospitalization ward&#46; The main element conditioning such close collaboration between our Departments was the introduction of NPPV in our range of therapeutic options&#46; The high mortality associated with the need for IMV<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;6</span></a> raised some doubts about admitting such patients to our Unit&#44; in view of the important care burden involved &#40;respiratory support&#44; vasoactive and renal therapy in many cases&#44; and the adoption of isolation measures&#41;&#44; and the ominous outcomes&#46; But the introduction of NPPV and the publication of studies<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;11&#8211;13</span></a> warranting the use of this technique in immune depressed patients led to a substantial change in admission policy&#46; Another consideration was the rapid development and severity of organ dysfunction in these patients&#44; making it futile to admit such cases of established multiorgan failure to the ICU&#46; Early intervention with early admission thus proved essential&#46; In this same line&#44; some studies<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> point to the benefits in terms of lessened mortality of admitting patients with hematological malignancies to the ICU based on a less restrictive admission policy&#46; In this sense&#44; consideration is also required of the fact that a delay in admission to the ICU is directly correlated to mortality&#8211;thus advocating early patient admission&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">In this scenario favorable to NPPV&#44; doubts remain as to why the technique is still underused&#46; The reason could be the high incidence of ARDS upon admission or during patient stay in the ICU&#44; and the controversial indication of NPPV in ARDS&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;26&#44;27</span></a> Different studies<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">28&#44;29</span></a> have shown NPPV in hypoxemic patients to be more effective than oxygen therapy&#44; with particular emphasis upon ALI or ARDS<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">30&#8211;32</span></a>&#8211;registering an NPPV failure rate of between 4&#46;8&#37;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a> and 70&#37; in ALI&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> and between 46&#37;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> and 51&#37; in patients with ARDS&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a> The multivariate analysis<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">28&#44;33</span></a> found the development of ARDS to be a predictor of NPPV failure&#8211;this possibly being the reason why there is no clear recommendation on the use of NPPV in the context of ARDS&#44;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10&#44;25</span></a> and why the technique is little used in hematological patients with severe hypoxemia&#46; In contrast&#44; however&#44; the relationship between IMV and mortality in this patient population has been well established&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;5&#44;20&#8211;22</span></a> In this sense&#44; a multicenter observational study<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> involving a series of 1302 hematological patients with ARF showed the use of NPPV to be less widespread than that of IMV &#40;21&#37; vs 79&#37;&#41;&#46; The noninvasive group presented more neutropenia &#40;16&#46;8&#37; vs 10&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41; and hypoxemia than the invasive ventilation group&#46; In contrast&#44; the patients in the IMV group were in more serious condition as established by the APACHE score&#44; and had a poorer level of consciousness&#46; This may have justified the initial use of IMV&#46; A significant difference was also noted in the use of NPPV versus IMV in patients with ALI &#40;21&#37; vs 11&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#46; In the case of patients with ARDS&#44; the difference failed to reach statistical significance&#46; The results showed the NPPV group to have a shorter duration of mechanical ventilation and stay in the ICU&#44; as well as lesser mortality both in the ICU and in hospital&#44; but these results were not reproduced in the subgroup of patients with ALI or ARDS&#46; Another observational study<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> found mortality after 30 days in the NPPV group to be significantly lower than in the IMV group &#40;43&#46;7&#37; vs 70&#46;8&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">On analyzing the NPPV group&#44; failure of the technique was seen to be associated with a greater complications rate&#46; These results coincide with those obtained in other studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;22&#44;24&#44;30</span></a> where the failure of NPPV markedly increased the percentage of complications&#44; the duration of stay&#44; and mortality&#46; In coincidence with other authors&#44;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;22&#44;27&#44;28</span></a> we found mortality to be associated with failure of NPPV and development of ARDS&#44; along with other variables<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;22</span></a> such as age&#44; septic shock&#44; coma&#44; coagulation disorders or a high SAPS 2 score&#44; which were not analyzed in our series&#46; Given the strong negative influence of NPPV failure upon mortality&#44; it seems logical to explore the factors that influence such failure&#46; In this context&#44; different studies<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24&#44;28</span></a> have identified delayed introduction of ventilatory support&#44; the development of ARDS&#44; and the need for vasoactive and renal support as predictors of NPPV failure&#46; Another cohort study of patients with ARDS<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> found severity as determined by a SAPS 2 score of &#62;34&#44; and the absence of improvement in oxygenation &#40;PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>175&#41; 60<span class="elsevierStyleHsp" style=""></span>min after starting NPPV&#44; to be predictors of failure&#46; From the above it can be concluded that NPPV will probably fail if the start of the technique is delayed in a hypoxemic patient with scant clinical and blood gas response after 1<span class="elsevierStyleHsp" style=""></span>h&#8211;intubation being required in such cases&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The limitations of our study are represented by its retrospective nature&#44; and the fact that it was carried out in a single center where NPPV moreover is routine practice in patients with hypoxemic ARF&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Despite the poor results obtained in the IMV group&#44; we do not intend to discard the use of the technique&#46; Rather&#44; we wish to underscore the benefits of NPPV in extremely ill patients&#44; with a poor prognosis and with multiple organ dysfunction&#46; The routine use of NPPV&#44; and the risk of intubation particularly in these patients&#44; implies that the few individuals directly included in the IMV group were in a condition in which NPPV was literally contraindicated&#46; The conduction of a prospective study comparing NPPV versus IMV with a literature basis<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;5&#44;7</span></a> demonstrating the mortality associated to IMV&#44; along with studies<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;22</span></a> showing the good results obtained with NPPV&#44; therefore would be very questionable&#46; Consequently&#44; on the basis of our results&#44; we could recommend the use of NPPV as a first ventilatory support measure in hematological patients with ARF&#44; without considering the classical NPPV indication criteria&#44;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;26&#44;27</span></a> and without regarding ARDS or multiorgan dysfunction as exclusion criteria&#8211;since at the time of admission to the ICU&#44; most of these patients already suffer dysfunction of one or more organ systems&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflicts of interest</span><p id="par0120" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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          "titulo" => "Keywords"
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          "palabras" => array:5 [
            0 => "Hematological malignancy"
            1 => "Noninvasive positive pressure ventilation"
            2 => "Pneumonia"
            3 => "Invasive mechanical ventilation"
            4 => "Acute respiratory failure"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec279512"
          "palabras" => array:5 [
            0 => "Enfermedad hematol&#243;gica"
            1 => "Ventilaci&#243;n mec&#225;nica no invasiva"
            2 => "Neumon&#237;a"
            3 => "Ventilaci&#243;n mec&#225;nica invasiva"
            4 => "Insuficiencia respiratoria aguda"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A comparison was made between invasive mechanical ventilation &#40;IMV&#41; and noninvasive positive pressure ventilation &#40;NPPV&#41; in hematological patients with acute respiratory failure&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Design</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A retrospective observational study was made from 2001 to December 2011&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">Setting</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A clinical&#8211;surgical intensive care unit &#40;ICU&#41; in a tertiary hospital&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Patients</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Patients with hematological malignancies suffering acute respiratory failure &#40;ARF&#41; and requiring mechanical ventilation in the form of either IMV or NPPV&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0030">Variables of interest</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Analysis of infection and organ failure rates&#44; duration of mechanical ventilation and ICU and hospital stays&#44; as well as ICU&#44; hospital and mortality after 90 days&#46; The same variables were analyzed in the comparison between NPPV success and failure&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Forty-one patients were included&#44; of which 35 required IMV and 6 NPPV&#46; ICU mortality was higher in the IMV group &#40;100&#37; vs 37&#37; in NPPV&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;006&#41;&#46; The intubation rate in NPPV was 40&#37;&#46; Compared with successful NPPV&#44; failure in the NPPV group involved more complications&#44; a longer duration of mechanical ventilation and ICU stay&#44; and greater ICU and hospital mortality&#46; Multivariate analysis of mortality in the NPPV group identified NPPV failure &#40;OR 13 &#91;95&#37; CI 1&#46;33&#8211;77&#46;96&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;008&#41; and progression to acute respiratory distress syndrome &#40;OR 10 &#91;95&#37; CI 1&#46;95&#8211;89&#46;22&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;03&#41; as prognostic factors&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0040">Conclusion</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The use of NPPV reduced mortality compared with IMV&#46; NPPV failure was associated with more complications&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0050">Objetivo</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Comparaci&#243;n de la ventilaci&#243;n mec&#225;nica invasiva &#40;VMI&#41; frente a la no invasiva &#40;VMNI&#41; en pacientes hematol&#243;gicos que desarrollaron insuficiencia respiratoria aguda &#40;IRA&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0055">Dise&#241;o</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional retrospectivo desde 2001 y hasta diciembre de 2011&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0060">&#193;mbito</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Unidad de cuidados intensivos &#40;UCI&#41; m&#233;dico-quir&#250;rgica de un hospital de tercer nivel&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0065">Pacientes</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Aquellos con patolog&#237;a hematol&#243;gica con IRA y que precisaron ventilaci&#243;n mec&#225;nica &#40;VM&#41;&#44; tanto VMI como VMNI&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0070">Variables de inter&#233;s</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">N&#250;mero de infeccciones y fracaso de &#243;rganos&#44; duraci&#243;n de VM y estancias en la unidad y hospitalaria&#44; as&#237; como mortalidad en UCI&#44; hospitalaria y a los 90 d&#237;as&#46; En el subgrupo de VMNI se compar&#243; &#233;xito y fracaso en cuanto a las variables mencionadas&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 41 pacientes que precisaron VM&#44; 35 con VMNI y 6 con VMI&#46; La mortalidad en UCI fue superior en VMI &#40;100 vs 37&#37; en VMNI&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#41;&#46; El porcentaje de intubaci&#243;n en VMNI fue del 40&#37;&#46; El grupo fracaso de VMNI present&#243; mayor tasa de complicaciones&#44; mayor duraci&#243;n de la VM&#44; mayor estancia en UCI&#44; as&#237; como de mortalidad en UCI y hospitalaria que el grupo que no precis&#243; intubaci&#243;n&#46; El an&#225;lisis multivariante de mortalidad en el grupo VMNI estaba relacionada con el fracaso de la VMNI &#40;OR 13 &#91;IC 95&#37; 1&#44;33&#8211;77&#44;96&#93;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;008&#41; y el desarrollo de s&#237;ndrome de distr&#233;s respiratorio del adulto &#40;OR 10 &#91;IC 95&#37; 1&#44;95&#8211;89&#44;22&#93;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0080">Conclusi&#243;n</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">La utilizaci&#243;n de VMNI redujo la mortalidad en comparaci&#243;n con la VMI&#46; El fracaso de la VMNI llev&#243; aparejada una mayor tasa de complicaciones&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0070">Please cite this article as&#58; Belenguer-Muncharaz A&#44; Albert-Rodrigo L&#44; Ferrandiz-Sell&#233;s A&#44; Cebri&#225;n-Graullera G&#46; Evoluci&#243;n de 10 a&#241;os de aplicaci&#243;n de la ventilaci&#243;n mec&#225;nica en la insuficiencia respiratoria aguda del paciente hematol&#243;gico ingresado en la unidad de cuidados intensivos&#46; Med Intensiva&#46; 2013&#59;37&#58;452&#8211;460&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2106
            "Ancho" => 2918
            "Tamanyo" => 200270
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Kaplan&#8211;Meier survival analysis &#40;log-rank test&#41; between the NPPV group &#40;success and failure&#41; and the IMV group after 90 days&#46; Table&#58; number of patients alive during this period of time&#46; IMV&#44; invasive mechanical ventilation&#59; NPPV&#44; noninvasive positive pressure ventilation&#59; NPPV OTI&#44; intubated noninvasive ventilation&#59; NPPV-NO OTI&#44; non-intubated noninvasive ventilation&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">CPAP&#44; continuous positive airway pressure&#59; COPD&#44; chronic obstructive pulmonary disease&#59; ARF&#44; acute respiratory failure&#59; SAPS 2&#44; Simplified Acute Physiology Score &#40;range 0&#8211;56&#41;&#59; SOFA&#44; Sequential Organ Failure Assessment&#59; TRALI&#44; transfusion-related acute lung injury&#59; ICU&#44; Intensive Care Unit&#59; IMV&#44; invasive mechanical ventilation&#59; NPPV&#44; noninvasive positive pressure ventilation&#46;</p>"
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                  \t\t\t\t"><span class="elsevierStyleItalic">SOFA</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">SAPS 2 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Origin of patients&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Operating room&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Arterial hypertension&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Congestive heart failure&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Previous cancer<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Smoking&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Chronic renal failure&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Neutropenia&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Type of hematological disease</span></td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Acute leukemia&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Non-Hodgkin lymphoma&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Multiple myeloma&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Others<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">e</span></a>&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Cause of acute respiratory failure</span>&#44; n &#40;&#37;&#41;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Acute lung edema&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Postoperative ARF&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TRALI&nbsp;\t\t\t\t\t\t\n
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          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">ARDS&#44; adult respiratory distress syndrome&#59; ICU&#44; Intensive Care Unit&#59; IMV&#44; invasive mechanical ventilation&#59; NPPV&#44; noninvasive positive pressure ventilation&#59; VAP&#44; ventilator associated pneumonia&#46;</p>"
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                  \t\t\t\t" style="border-bottom: 2px solid black">NPPV &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>35&#41;</td><td class="td" title="\n
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                  \t\t\t\t">IMV &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">p</span><a class="elsevierStyleCrossRef" href="#tblfn0050"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">SuccessNPPV&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">VAP&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Secondary bacteremia</span><a class="elsevierStyleCrossRef" href="#tblfn0060"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Hepatic</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;36&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Neurological</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">4 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;000&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;169&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Cardiac arrest&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">3 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;056&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Barotrauma&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;000&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Tracheostomy&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Duration mechanical ventilation</span><a class="elsevierStyleCrossRef" href="#tblfn0065"><span class="elsevierStyleSup">b</span></a>&#44; <span class="elsevierStyleBold">days</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;016&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Stay in ICU</span><a class="elsevierStyleCrossRef" href="#tblfn0065"><span class="elsevierStyleSup">b</span></a>&#44; <span class="elsevierStyleBold">days</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;025&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;190&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Stay in hospital</span><a class="elsevierStyleCrossRef" href="#tblfn0065"><span class="elsevierStyleSup">b</span></a>&#44; <span class="elsevierStyleBold">days</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>19&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>21&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;800&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>26&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;554&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Mortality in ICU&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;37&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">10 &#40;71&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#46;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Causes of death</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Multiorgan failure&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Cardiac arrest&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Cerebral hemorrhage&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Refractory hypoxemia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Mortality in hospital&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">16 &#40;46&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">6 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">10 &#40;71&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;018&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">6 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;023&nbsp;\t\t\t\t\t\t\n
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0060">Secondary bacteremia foci&#58; pulmonary &#40;2 cases&#41;&#44; urinary &#40;3 cases&#41;&#44; abdominal &#40;1 case&#41; and blood product bag infection by <span class="elsevierStyleItalic">Klebsiella oxytoca</span> &#40;1 case&#41;&#46;</p>"
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          "leyenda" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">95&#37; CI&#44; 95&#37; confidence interval&#59; CRA&#44; cardiorespiratory arrest&#59; ARDS&#44; adult respiratory distress syndrome&#59; NPPV&#44; noninvasive positive pressure ventilation&#46;</p>"
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                  \t\t\t\t" style="border-bottom: 2px solid black">NPPV survivors &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>22&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Odds ratio&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">6 &#40;46&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;236&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Failure NPPV&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">10 &#40;77&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">13&#46;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;33 &#8211; 77&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;008&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Hemodynamic failure&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">11 &#40;84&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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Article information

ISSN: 21735727
Original language: English

DOI:10.1016/j.medine.2012.12.007

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Year/Month	Html	Pdf	Total

2024 November	14	7	21
2024 October	61	34	95
2024 September	62	26	88
2024 August	72	33	105
2024 July	39	35	74
2024 June	59	44	103
2024 May	36	29	65
2024 April	54	35	89
2024 March	40	32	72
2024 February	32	47	79
2024 January	43	58	101
2023 December	27	62	89
2023 November	47	60	107
2023 October	36	42	78
2023 September	52	42	94
2023 August	30	17	47
2023 July	34	21	55
2023 June	32	22	54
2023 May	44	36	80
2023 April	25	22	47
2023 March	70	36	106
2023 February	63	39	102
2023 January	28	27	55
2022 December	58	46	104
2022 November	78	39	117
2022 October	54	48	102
2022 September	43	34	77
2022 August	37	45	82
2022 July	45	34	79
2022 June	37	41	78
2022 May	51	37	88
2022 April	42	55	97
2022 March	53	42	95
2022 February	33	32	65
2022 January	40	36	76
2021 December	39	46	85
2021 November	41	39	80
2021 October	42	55	97
2021 September	44	39	83
2021 August	55	51	106
2021 July	37	49	86
2021 June	65	20	85
2021 May	89	49	138
2021 April	123	64	187
2021 March	77	42	119
2021 February	44	27	71
2021 January	71	37	108
2020 December	46	33	79
2020 November	55	17	72
2020 October	56	35	91
2020 September	35	23	58
2020 August	39	19	58
2020 July	38	19	57
2020 June	28	21	49
2020 May	47	21	68
2020 April	57	30	87
2020 March	32	18	50
2020 February	69	73	142
2020 January	47	32	79
2019 December	47	15	62
2019 November	32	26	58
2019 October	29	15	44
2019 September	35	24	59
2019 August	32	10	42
2019 July	33	32	65
2019 June	20	17	37
2019 May	36	20	56
2019 April	23	26	49
2019 March	23	25	48
2019 February	32	33	65
2019 January	37	32	69
2018 December	43	66	109
2018 November	114	71	185
2018 October	139	27	166
2018 September	24	8	32
2018 August	21	7	28
2018 July	23	6	29
2018 June	28	6	34
2018 May	26	5	31
2018 April	23	7	30
2018 March	20	3	23
2018 February	26	10	36
2018 January	38	13	51
2017 December	26	5	31
2017 November	32	10	42
2017 October	35	6	41
2017 September	29	10	39
2017 August	20	11	31
2017 July	23	10	33
2017 June	38	10	48
2017 May	28	24	52
2017 April	26	15	41
2017 March	21	4	25
2017 February	19	9	28
2017 January	20	6	26
2016 December	46	7	53
2016 November	48	9	57
2016 October	50	15	65
2016 September	47	12	59
2016 August	36	6	42
2016 July	23	8	31
2016 June	1	0	1
2016 April	2	0	2
2016 February	2	0	2
2015 December	2	0	2

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