Observational studyThe western journal of emergency medicine2017
Duration of Mechanical Ventilation in the Emergency Department.
Observational study in The western journal of emergency medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06157073 (A Randomized, Controlled Trial to Evaluate the Efficacy and Safety of Fully Automated Closed-loop Ventilator Versus Conventional Open-loop Ventilator in Ventilated Patients in the Emergency Department), which is not on this map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized, Controlled Trial to Evaluate the Efficacy and Safety of Fully Automated Closed-loop Ventilator Versus Conventional Open-loop Ventilator in Ventilated Patients in the Emergency Department
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Levosimendan vs. Milrinone in cardiac surgery: A GRADE-assessed systematic review and meta-analysis.European journal of clinical pharmacology · 2026Pooled it
- Use of etomidate in endotracheal intubations in the emergency room during the COVID-19 pandemic: a randomized clinical trial.Acta cirurgica brasileira · 2024Trial
- Enhancing Care for Critically Ill Patients Boarding in the Emergency Department: A 360° Evaluation of an Emergency Medicine Critical Care Fellow Model.Journal of the American College of Emergency Physicians open · 2026Article
- Association between prolonged Emergency Department stay and Intensive Care Unit mortality among patients at a tertiary hospital in Ethiopia.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2026Article
- Patient and staff safety implications of emergency department boarding: a systematic review.Health affairs scholar · 2026Review
- Diaphragmatic dysfunction assessed by ultrasound: a key predictor of prolonged ventilation in emergency department.Internal and emergency medicine · 2026Observational
- Management of Mechanical Ventilation in Emergency Medicine: A Scoping Review.Journal of the American College of Emergency Physicians open · 2026Review
- Post-intubation sedation in the emergency department: A scoping review.The American journal of emergency medicine · 2026Article
- Predictors of Mortality in Medical ICU Patients: A Retrospective Study in a Tertiary Care Center in Jordan.Journal of clinical medicine · 2025Article
- Outcomes of critically ill COVID-19 patients boarding in the emergency department of a tertiary care center in a developing country: a retrospective cohort study.International journal of emergency medicine · 2023Article
- Optimal Concentration and Duration of Endotracheal Tube Coating to Achieve Optimal Antimicrobial Efficacy and Safety Balance: An In Vitro Study.Gels (Basel, Switzerland) · 2023Article
- Initiation of a Lung Protective Ventilation Strategy in the Emergency Department: Does an Emergency Department-Based ICU Make a Difference?Critical care explorations · 2022Article
- Emergency Department Management of Severe Hypoxemic Respiratory Failure in Adults With COVID-19.The Journal of emergency medicine · 2021Review
- Boarding of critically Ill patients in the emergency department.Journal of the American College of Emergency Physicians open · 2020Article
- Boarding of Critically Ill Patients in the Emergency Department.Critical care medicine · 2020Review
- The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients.Journal of critical care · 2019Observational
- Invasive mechanical ventilation in the emergency department.Turkish journal of emergency medicine · 2019Review
- Development and validation of a questionnaire to assess the knowledge of mechanical ventilation in urgent care among students in their last-year medical course in Brazil.Clinics (Sao Paulo, Brazil) · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDue to hospital crowding, mechanically ventilated patients are increasingly spending hours boarding in emergency departments (ED) before intensive care unit (ICU) admission. This study aims to evaluate the association between time ventilated in the ED and in-hospital mortality, duration of mechanical ventilation, ICU and hospital length of stay (LOS).
methodsThis was a multi-center, prospective, observational study of patients ventilated in the ED, conducted at three academic Level I Trauma Centers from July 2011 to March 2013. All consecutive adult patients on invasive mechanical ventilation were eligible for enrollment. We performed a Cox regression to assess for a mortality effect for mechanically ventilated patients with each hour of increasing LOS in the ED and multivariable regression analyses to assess for independently significant contributors to in-hospital mortality. Our primary outcome was in-hospital mortality, with secondary outcomes of ventilator days, ICU LOS and hospital LOS. We further commented on use of lung protective ventilation and frequency of ventilator changes made in this cohort.
resultsWe enrolled 535 patients, of whom 525 met all inclusion criteria. Altered mental status without respiratory pathology was the most common reason for intubation, followed by trauma and respiratory failure. Using iterated Cox regression, a mortality effect occurred at ED time of mechanical ventilation > 7 hours, and the longer ED stay was also associated with a longer total duration of intubation. However, adjusted multivariable regression analysis demonstrated only older age and admission to the neurosciences ICU as independently associated with increased mortality. Of interest, only 23.8% of patients ventilated in the ED for over seven hours had changes made to their ventilator.
conclusionIn a prospective observational study of patients mechanically ventilated in the ED, there was a significant mortality benefit to expedited transfer of patients into an appropriate ICU setting.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.