2). In Figure Figure3,3, we depicted the ICU and hospital mortality rates for each category of ARDS. The combined ICU mortality for ARDS moderate and severe (the former definition of ARDS [20]) was 55% and the hospital mortality was 60%.Figure 3ICU and hospital mortality rates according to the Berlin definition of ARDS. P < 0.001 www.selleckchem.com/products/arq-197.html (Pearson Chi-square test) for the comparison of hospital mortality and ARDS classification. ARDS, acute respiratory distress syndrome; ICU, intensive care unit. …Non-invasive ventilation characteristics and failureThe characteristics of patients that initially received NIV are shown in Table Table3.3. The most common diagnoses were pneumonia (23%), neurologic disorders (21%) and non-pulmonary sepsis (12%).

Classical indications for NIV, such as obstructive pulmonary disease and congestive heart failure, were present in only 5% and 8% of the cases, respectively. NIV failure occurred in 54% (81/151) of patients receiving NIV initially. Factors related to NIV failure in univariate analysis were total SOFA score, SOFA score excluding respiratory component, ARDS diagnosis, length of NIV, tracheostomy, use of vasopressors and a positive cumulative fluid balance. As expected, ICU and hospital lengths of stay and mortality were higher in patients who experienced NIV failure (Table (Table3).3). In multivariate analysis, a SOFA score without the respiratory component �� 4 points, a diagnosis of ARDS and a cumulative fluid balance higher than 2 L in the first 72 hours of ICU stay were associated with NIV failure (Table (Table3).3).

The frequency of NIV failure as well as hospital mortality increased significantly with the number of these risk factors presented by the patients (Figure (Figure44).Table 3Factors associated with NIV failure on univariate and multivariate analysisFigure 4Interaction of risk factors for failure of non-invasive ventilation and hospital mortality. Fluid balance denotes cumulative fluid balance �� 2 L in the first 72 hours of intensive care unit stay. SOFA score denotes Sequential Organ Failure Assessment …Weaning and tracheostomyTable Table44 depicts the variables related to weaning in our population. Carrying out a spontaneous breathing trial and a successful extubation were protective factors for mortality in the univariate analysis. Additionally, 30% of the patients that were successfully extubated received non-invasive ventilation after extubation.

Weaning failure with subsequent reintubation occurred in 15% of the patients. Tracheostomy was carried out in 182 (29%) patients under invasive mechanical ventilation 7 (5 to 11) days after endotracheal intubation.Table 4Weaning variables of patients under invasive mechanical ventilationDiscussionIn the present study, mortality rates of patients in Brazilian AV-951 ICUs requiring ventilatory support were elevated, regardless of the underlying condition.