Table 3 Hospital (second hit) exposures that may modify the development of ALI in high risk patients.
From: Towards the prevention of acute lung injury: a population based cohort study protocol
| Â | Variable | Measurements |
|---|---|---|
A. Exposures associated with development of ALI in preliminary studies | ||
Treatment of infection | Antibiotics | Time to administration of adequate antibiotics |
| Â | Source control | List source, time to source control |
Shock resuscitation | Early goal directed resuscitation | Time to completion of goal directed resuscitation |
Blood transfusion | Red blood cells, fresh frozen plasma, platelets | Number of units, donor gender and pregnancies, storage age of red cells and platelets |
Respiratory support | Inspired oxygen concentration (FIO2) | AUC, mean, median and maximum value during the exposure time of interest |
| Â | Ventilator tidal volumes (mL/kg predicted weight) | AUC, mean, median and maximum value during the exposure time of interest |
| Â | Peak and plateau airway pressures (cm H2O) | AUC, mean, median and maximum value during the exposure time of interest |
| Â | PEEP (cm H2O) | 5-10 (reference), <5, >10 cm H2O |
| Â | Respiratory rate | AUC, mean, median and maximum value during the exposure time of interest |
Medications | Amiodarone | Cumulative dose during the exposure time of interest |
| Â | Chemotherapy | Cumulative dose during the exposure time of interest |
Other complications | Aspiration (in hospital) | Inhalation of food or gastric contents |
| Â | Medical or surgical misadventures | List complication (ICD-9 code E870-E879.9) |
B. Additional biologically plausible hospital exposures - exploratory analysis | ||
Mechanism | Variable | Measurements |
Inflammation | Corticosteroids, inhaled and systemic | Cumulative dose during the exposure time |
| Â | Statins | Cumulative dose during the exposure time |
| Â | Insulin | Cumulative dose during the exposure time |
| Â | ACE inhibitor | Cumulative dose during the exposure time |
Oxidative stress | Antioxidants: N-Acetylcysteine, vitamin C, Vit E, Ω 3 fatty acids | Cumulative dose during the exposure time |
Coagulation | Anticoagulants (heparin, coumadin) | Cumulative dose during the exposure time |
| Â | Antiplatelet agents (aspirin, clopidogrel) | Cumulative dose during the exposure time |
Aspiration | Head of the bed position | Above horizontal |
| Â | Gastric tube feeding | Cumulative dose during the exposure time |
| Â | Sedative agents | Cumulative dose during the exposure time |
| Â | Narcotics | Cumulative dose during the exposure time |
| Â | Antipsychotics | Cumulative dose during the exposure time |
| Â | Gastric acid agents (H2 blockers, PPIs) | Cumulative dose during the exposure time |
Metabolic | IV fluid (saline, Ringer, albumin) | Cumulative dose during the exposure time |
| Â | Furosemide | Cumulative dose during the exposure time |
| Â | Beta agonists, inhaled and systemic | Cumulative dose during the exposure time |
| Â | Laboratory findings: albumin, pH, glucose, osmolarity | The worst value during the exposure time of interest |