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Table 1 Comparison of patients with acute respiratory distress syndrome with or without diffuse alveolar damage patterns at histological examination

From: Predictors of diffuse alveolar damage in patients with acute respiratory distress syndrome: a retrospective analysis of clinical autopsies

  ARDS without DAD (n = 197) ARDS with DAD (n = 159) p Value
Characteristics of the patients
 Age, years 66.4 ± 14.0 64.3 ± 14.7 0.17
 Female sex, n (%) 58 (29.4%) 68 (42.8%) 0.01
 SAPS II, points 55.5 ± 19.6 50.9 ± 16.1 0.02
 Duration of MV before death, days 12.7 ± 21.7 13.1 ± 11.0 0.82
 Duration of ARDS evolution ≥ 72 h, n (%) 101 (51%) 128 (81%) <0.01
Risk factor triggering ARDS
 Pneumonia, n (%) 62 (31.5%) 66 (41.5%) 0.04
 Other pulmonary risk factors of ARDS, n (%) 12 (6.1%) 7 (4.4%) 0.48
 Shock, n (%) 118 (59.9%) 83 (52.2%) 0.14
 Extrapulmonary sepsis, n (%) 73 (37.1%) 56 (35.2%) 0.72
 Pancreatitis, n (%) 12 (6.1%) 7 (4.4%) 0.48
Blood gases
 PaO2, mmHg 93 ± 37 79 ± 27 <0.01
 PaO2/FiO2, mmHg 140 ± 67 104 ± 53 <0.01
 PaCO2, mmHg 44.5 ± 12.8 49.1 ± 15.0 <0.01
Severity of hypoxemia    <0.01
 200 < PaO2/FiO2 ≤ 300 mmHg, n (%) 43 (22%) 6 (4%)  
 100 < PaO2/FiO2 ≤ 200 mmHg, n (%) 85 (43%) 56 (35%)
 PaO2/FiO2 ≤ 100 mmHg, n (%) 69 (35%) 97 (61%)
Ventilatory settings
 Tidal volume, ml 620 ± 133 623 ± 157 0.87
 Respiratory rate, cycles/minute 20 ± 6 22 ± 7 <0.01
 Minute ventilation, L/minute 11.9 ± 3.2 13.1 ± 3.4 <0.01
 FiO2 0.75 ± 0.25 0.85 ± 0.22 <0.01
 PEEP, cmH2O 7.9 ± 4.5 9.6 ± 4.1 <0.01
 PEEP ≥ 10 cmH2O, n (%) 91 (46%) 106 (67%) <0.01
Physiological parameters
 Peak pressure, cmH2O 37 ± 10 44 ± 10 <0.01
 Dynamic driving pressure (peak − PEEP), cmH2O 28 ± 11 34 ± 9 <0.01
 Dynamic compliance, ml/cmH2O 24 ± 11 20 ± 7 <0.01
 Dynamic compliance < 40 ml/cmH2O, n (%) 174 (88%) 155 (97%) <0.01
 VE corrected PaCO2, L/minute 13 ± 5 16 ± 7 <0.01
 VE corrected PaCO2 ≥ 10 L/minute, n (%) 135 (69%) 133 (84%) <0.01
Extent of infiltrates on chest radiograph    <0.01
 Two quadrants, n (%) 64 (32%) 17 (11%)  
 Three quadrants, n (%) 63 (32%) 41 (26%)
 Four quadrants, n (%) 70 (36%) 101 (63%)
Lung weight at autopsy examination, g 1567 ± 709 1848 ± 748 <0.01
  1. Abbreviations: ARDS Acute respiratory distress syndrome, DAD Diffuse alveolar damage, MV Mechanical ventilation, SAPS Simplified Acute Physiology Score II, PEEP Positive end-expiratory pressure, VE Minute ventilation, PaCO 2 Partial pressure of arterial carbon dioxide, PaO 2 , Partial pressure of arterial oxygen, PaO 2 /FiO 2 Ratio of partial pressure of arterial oxygen to fraction of inspired oxygen