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Pre-admission air pollution exposure prolongs the duration of ventilation in intensive care patients

PURPOSE: Air pollutant exposure constitutes a serious risk factor for the emergence or aggravation of (existing) pulmonary disease. The impact of pre-intensive care ambient air pollutant exposure on the duration of artificial ventilation was, however, not yet established. METHODS: The medical record...

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Autores principales: De Weerdt, Annick, Janssen, Bram G., Cox, Bianca, Bijnens, Esmée M., Vanpoucke, Charlotte, Lefebvre, Wouter, El Salawi, Omar, Jans, Margot, Verbrugghe, Walter, Nawrot, Tim S., Jorens, Philippe G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7224020/
https://www.ncbi.nlm.nih.gov/pubmed/32185459
http://dx.doi.org/10.1007/s00134-020-05999-3
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author De Weerdt, Annick
Janssen, Bram G.
Cox, Bianca
Bijnens, Esmée M.
Vanpoucke, Charlotte
Lefebvre, Wouter
El Salawi, Omar
Jans, Margot
Verbrugghe, Walter
Nawrot, Tim S.
Jorens, Philippe G.
author_facet De Weerdt, Annick
Janssen, Bram G.
Cox, Bianca
Bijnens, Esmée M.
Vanpoucke, Charlotte
Lefebvre, Wouter
El Salawi, Omar
Jans, Margot
Verbrugghe, Walter
Nawrot, Tim S.
Jorens, Philippe G.
author_sort De Weerdt, Annick
collection PubMed
description PURPOSE: Air pollutant exposure constitutes a serious risk factor for the emergence or aggravation of (existing) pulmonary disease. The impact of pre-intensive care ambient air pollutant exposure on the duration of artificial ventilation was, however, not yet established. METHODS: The medical records of 2003 patients, admitted to the intensive care unit (ICU) of the Antwerp University Hospital (Flanders, Belgium), who were artificially ventilated on ICU admission or within 48 h after admission, for the duration of at least 48 h, were analyzed. For each patient’s home address, daily air pollutant exposure [particulate matter with an aerodynamic diameter ≤ 2.5 µm (PM(2.5)) and ≤ 10 µm (PM(10)), nitrogen dioxide (NO(2)) and black carbon (BC)] up to 10 days prior to hospital admission was modeled using a high-resolution spatial–temporal model. The association between duration of artificial ventilation and air pollution exposure during the last 10 days before ICU admission was assessed using distributed lag models with a negative binomial regression fit. RESULTS: Controlling for pre-specified confounders, an IQR increment in BC (1.2 µg/m(3)) up to 10 days before admission was associated with an estimated cumulative increase of 12.4% in ventilation duration (95% CI 4.7–20.7). Significant associations were also observed for PM(2.5), PM(10) and NO(2), with cumulative estimates ranging from 7.8 to 8.0%. CONCLUSION: Short-term ambient air pollution exposure prior to ICU admission represents an unrecognized environmental risk factor for the duration of artificial ventilation in the ICU. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00134-020-05999-3) contains supplementary material, which is available to authorized users.
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spelling pubmed-72240202020-05-15 Pre-admission air pollution exposure prolongs the duration of ventilation in intensive care patients De Weerdt, Annick Janssen, Bram G. Cox, Bianca Bijnens, Esmée M. Vanpoucke, Charlotte Lefebvre, Wouter El Salawi, Omar Jans, Margot Verbrugghe, Walter Nawrot, Tim S. Jorens, Philippe G. Intensive Care Med Original PURPOSE: Air pollutant exposure constitutes a serious risk factor for the emergence or aggravation of (existing) pulmonary disease. The impact of pre-intensive care ambient air pollutant exposure on the duration of artificial ventilation was, however, not yet established. METHODS: The medical records of 2003 patients, admitted to the intensive care unit (ICU) of the Antwerp University Hospital (Flanders, Belgium), who were artificially ventilated on ICU admission or within 48 h after admission, for the duration of at least 48 h, were analyzed. For each patient’s home address, daily air pollutant exposure [particulate matter with an aerodynamic diameter ≤ 2.5 µm (PM(2.5)) and ≤ 10 µm (PM(10)), nitrogen dioxide (NO(2)) and black carbon (BC)] up to 10 days prior to hospital admission was modeled using a high-resolution spatial–temporal model. The association between duration of artificial ventilation and air pollution exposure during the last 10 days before ICU admission was assessed using distributed lag models with a negative binomial regression fit. RESULTS: Controlling for pre-specified confounders, an IQR increment in BC (1.2 µg/m(3)) up to 10 days before admission was associated with an estimated cumulative increase of 12.4% in ventilation duration (95% CI 4.7–20.7). Significant associations were also observed for PM(2.5), PM(10) and NO(2), with cumulative estimates ranging from 7.8 to 8.0%. CONCLUSION: Short-term ambient air pollution exposure prior to ICU admission represents an unrecognized environmental risk factor for the duration of artificial ventilation in the ICU. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00134-020-05999-3) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2020-03-17 2020 /pmc/articles/PMC7224020/ /pubmed/32185459 http://dx.doi.org/10.1007/s00134-020-05999-3 Text en © Springer-Verlag GmbH Germany, part of Springer Nature 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original
De Weerdt, Annick
Janssen, Bram G.
Cox, Bianca
Bijnens, Esmée M.
Vanpoucke, Charlotte
Lefebvre, Wouter
El Salawi, Omar
Jans, Margot
Verbrugghe, Walter
Nawrot, Tim S.
Jorens, Philippe G.
Pre-admission air pollution exposure prolongs the duration of ventilation in intensive care patients
title Pre-admission air pollution exposure prolongs the duration of ventilation in intensive care patients
title_full Pre-admission air pollution exposure prolongs the duration of ventilation in intensive care patients
title_fullStr Pre-admission air pollution exposure prolongs the duration of ventilation in intensive care patients
title_full_unstemmed Pre-admission air pollution exposure prolongs the duration of ventilation in intensive care patients
title_short Pre-admission air pollution exposure prolongs the duration of ventilation in intensive care patients
title_sort pre-admission air pollution exposure prolongs the duration of ventilation in intensive care patients
topic Original
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7224020/
https://www.ncbi.nlm.nih.gov/pubmed/32185459
http://dx.doi.org/10.1007/s00134-020-05999-3
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