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Acute respiratory distress syndrome in a University Hospital ICU in Japan
Critical Care volume 3, Article number: P033 (2000)
To determine prognostic factors for and the outcome of acute respiratory distress syndrome (ARDS) in our ICU.
The American-European consensus conference definition  was used for ARDS diagnosis. Thirty-three (2.1%) of 1588 patients admitted to the ICU met the criteria for ARDS. Mechanical ventilation with PEEP was performed for all patients with ARDS. Steroid pulse therapy (60%), nitric oxide inhalation (21%), surfactant replacement (9%), and neutrophil elastase inhibitor administration (24%) were also used. For determination of prognostic factors of ARDS, mean pulmonary arterial pressure (mPAP), pulmonary vascular resistance (PVR), and multiple organ dysfunction score (MODS)  excluding the Glasgow Coma Score were measured and compared with outcome.
There were 22 men and 11 women aged 61 ± 12 years. The mortality rate of ARDS was 73%. Sepsis was the main cause of ARDS accounting for 73% of cases. All ARDS patients with septic shock (n = 9) and with sterile shock  (n = 4) died. The patients with shock had higher MODS compared to those without shock with mortality rate 55%. There were no significant differences in mPAP and PVR between survivor and nonsurvivors. ARDS patients who had high MODS, especially those with low PaO2/FIO2 and high pressure-adjusted heart rate, 5 days after the onset of ARDS had a poor prognosis.
Shock and MODS, but not pulmonary hypertension, are important as prognostic factors for ARDS.
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Yukioka, H., Nakatani, K. Acute respiratory distress syndrome in a University Hospital ICU in Japan. Crit Care 3, P033 (2000). https://doi.org/10.1186/cc408
- Pulmonary Hypertension
- Acute Respiratory Distress Syndrome
- Pulmonary Vascular Resistance
- Neutrophil Elastase
- Glasgow Coma Score