Key messages? In severe ARDS patients ventilated never according to a strictly standardized lung-protection strategy, VAP increased crude ICU mortality.? However, after adjustment, VAP did not remain associated with ICU mortality.? Factors independently associated with an increased risk of acquiring VAP were male sex and admission Glasgow Coma Scale score.AbbreviationsARDS: acute respiratory distress syndrome; VAP: ventilator-associated pneumonia; NMBA: neuromuscular blocking agent; PaO2:FIO2: ratio of partial pressure of arterial oxygen to fraction of inspired oxygen; BAL: bronchoalveolar lavage; (CFU)/ml: colony-forming units per milliliter; SAPS II: Simplified Acute Physiology Score; SOFA: sequential organ failure assessment.Competing interestsGlaxo-SmithKline France provided the cisatracurium and placebo for the study.
Glaxo-SmithKline France gave 30 k� for the ACURASYS study (main investigator, Laurent Papazian).Authors’ contributionsLP, JMF, AR, DP, and FV were responsible for study concept and design; AG, GP, SJ, JMA, and EA, acquisition of the data; MF, KB, PA, JMF, and LP, analysis and interpretation of the data; JMF, LP, and AR, drafting of the manuscript; and EA, critical revision of the manuscript. All authors read and approved the final manuscript.Supplementary MaterialAdditional file 1:Multistate analysis procedure. Description of the multistate model and syntax used in the mstate package 0.2.6 of R development Core Team (2010).Click here for file(39K, DOCX)AcknowledgementsMarseille: H?pital Nord – J. Albanese, V. Blasco, M. Leone, F. Antonini, P.
Visintini; H?pital Sainte-Marguerite -D. Blayac, B. Eon, P. Michelet, P. Saux, D. Lambert, V. Fulachier; H?pital Sainte-Marguerite – C. Guervilly, J. Allardet-Servent, D. Demory, N. Embriaco, M. Gainnier, L. Papazian; H?pital Ambroise Par�� – J.M. Seghboyan, N. Beni Chougrane, R. Soundaravelou, A. Piera, M. Bonnetty. Paris: H?pital Saint-Louis – E. Azoulay. Besan?on: H?pital Jean Minjoz – D. Perez, G. Capellier, P. Midez, C. Patry, E. Laurent, E. Belle, J.C. Navellou. Clermont-Ferrand: H?pital H?tel-Dieu – J.M. Constantin, S. Cayot-Constantin, R. Guerin. Avignon: Centre Hospitalier – P. Courant, T. Signouret, K. Pavaday, P. Garcia, L. Delapierre, K. Debbat. Toulon: H?pital Font-Pr�� -J. Durand-Gasselin, G. Corno, A. Orlando, I. Granier, S.Y. Donati. Rennes: H?pital Pontchaillou -Y. Le Tulzo, S.
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