Intensive Care Medicine

, Volume 35, Issue 8, pp 1352–1361 | Cite as

Acute respiratory failure in intensive care units. FINNALI: a prospective cohort study

  • Rita LinkoEmail author
  • Marjatta Okkonen
  • Ville Pettilä
  • Juha Perttilä
  • Ilkka Parviainen
  • Esko Ruokonen
  • Jyrki Tenhunen
  • Tero Ala-Kokko
  • Tero Varpula
  • The FINNALI-study group



To evaluate the incidence, treatment and mortality of acute respiratory failure (ARF) in Finnish intensive care units (ICUs).

Study design

Prospective multicentre cohort study.


All adult patients in 25 ICUs were screened for use of invasive or non-invasive ventilatory support during an 8-week period. Patients needing ventilatory support for more than 6 h were included and defined as ARF patients. Risk factors for ARF and details of prior chronic health status were assessed. Ventilatory and concomitant treatments were evaluated and recorded daily throughout the ICU stay. ICU and 90-day mortalities were assessed.


A total of 958 (39%) from the 2,473 admitted patients were treated with ventilatory support for more than 6 h. Incidence of ARF, acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) was 149.5, 10.6 and 5.0/100,000 per year, respectively. Ventilatory support was started with non-invasive interfaces in 183 of 958 (19%) patients. Ventilatory modes allowing triggering of spontaneous breaths were preferred (81%). Median tidal volume/predicted body weight was 8.7 (7.6–9.9) ml/kg and plateau pressure 19 (16–23) cmH2O. The 90-day mortality of ARF was 31%.


While the incidence of ARF requiring ventilatory support is higher, the incidence of ALI and ARDS seems to be lower in Finland than previously reported in other countries. Tidal volumes are higher than recommended in the concept of lung protective strategy. However, restriction of peak airway pressure was used in the majority of ARF patients.


Acute respiratory failure Acute lung injury Acute respiratory distress syndrome Mechanical ventilation Outcome 



We thank the principal study nurse Raija Niemi and all investigators and study nurses of the FINNALI study in the participating hospitals. The study was supported by an EVO grant from Helsinki University Hospital (TYH7250), Instrumentarium Scientific Foundation, external funding for Critical Care Medicine Research Group in Tampere, Health Care Foundation of North Finland and EVO grants from North Karelia, South Savo and Satakunta Central Hospitals.

Supplementary material

134_2009_1519_MOESM1_ESM.doc (86 kb)
(DOC 87 kb)


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Rita Linko
    • 1
    Email author
  • Marjatta Okkonen
    • 1
  • Ville Pettilä
    • 2
  • Juha Perttilä
    • 3
  • Ilkka Parviainen
    • 4
  • Esko Ruokonen
    • 4
  • Jyrki Tenhunen
    • 5
  • Tero Ala-Kokko
    • 6
  • Tero Varpula
    • 1
  • The FINNALI-study group
  1. 1.Intensive Care Units, Department of Anaesthesia and Intensive Care Medicine, Division of SurgeryHelsinki University HospitalHelsinkiFinland
  2. 2.Department of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care Research CenterMonash UniversityMelbourneAustralia
  3. 3.Department of Anesthesia and Intensive Care MedicineTurku University HospitalTurkuFinland
  4. 4.Division of Intensive CareKuopio University HospitalKuopioFinland
  5. 5.Department of Intensive Care Medicine, Critical Care Medicine Research GroupTampere University HospitalTampereFinland
  6. 6.Division of Intensive Care, Department of AnesthesiologyOulu University HospitalOuluFinland

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