Article Text
Abstract
Introduction Current evidence on epidemiology and outcomes of invasively mechanically ventilated intensive care unit (ICU) patients is predominantly gathered in resource-rich settings. Patient casemix and patterns of critical illnesses, and probably also ventilation practices are likely to be different in resource-limited settings. We aim to investigate the epidemiological characteristics, ventilation practices and clinical outcomes of patients receiving mechanical ventilation in ICUs in Asia.
Methods and analysis PRoVENT-iMIC (study of PRactice of VENTilation in Middle-Income Countries) is an international multicentre observational study to be undertaken in approximately 60 ICUs in 11 Asian countries. Consecutive patients aged 18 years or older who are receiving invasive ventilation in participating ICUs during a predefined 28-day period are to be enrolled, with a daily follow-up of 7 days. The primary outcome is ventilatory management (including tidal volume expressed as mL/kg predicted body weight and positive end-expiratory pressure expressed as cm H2O) during the first 3 days of mechanical ventilation—compared between patients at no risk for acute respiratory distress syndrome (ARDS), patients at risk for ARDS and in patients with ARDS (in case the diagnosis of ARDS can be made on admission). Secondary outcomes include occurrence of pulmonary complications and all-cause ICU mortality.
Ethics and dissemination PRoVENT-iMIC will be the first international study that prospectively assesses ventilation practices, outcomes and epidemiology of invasively ventilated patients in ICUs in Asia. The results of this large study, to be disseminated through conference presentations and publications in international peer-reviewed journals, are of ultimate importance when designing trials of invasive ventilation in resource-limited ICUs. Access to source data will be made available through national or international anonymised datasets on request and after agreement of the PRoVENT-iMIC steering committee.
Trial registration number NCT03188770; Pre-results.
- Mechanical Ventilation
- Invasive Ventilation
- Ards
- Outcomes
- Middle-income Countries
- Resource-limited Settings
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Footnotes
Contributors LP, AGA, ASN, AMD and MJS were equally responsible for writing of the manuscript and participated in study design. FP and PP participated in study design and assisted in writing of the manuscript. AA, AB, KC, AF, RaH, ReH, MH, HAI, KI, SI, GK, BK, HM, BN, RP, SS, LT, SG, NNT, NMY and MGdA reviewed the manuscript and agreed with submission.
Funding This research received no specific grant from any funding agency in the public, commercial or not–for profit sectors.
Competing interests None declared.
Patient consent Not required.
Ethics approval The Oxford Tropical Research Ethical Committee at the University of Oxford, UK, exempted the study from ethical review on the 9 June 2017.
Provenance and peer review Not commissioned; externally peer reviewed.
Collaborators MORU, the Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand (www.tropmedres.ac). PROVE Network, the Protective Ventilation Network (www.provenet.eu).