Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada.
N Engl J Med. 2011 Apr 7;364(14):1293-304. doi: 10.1056/NEJMoa1011802.
There have been few detailed, in-person interviews and examinations to obtain follow-up data on 5-year outcomes among survivors of the acute respiratory distress syndrome (ARDS).
We evaluated 109 survivors of ARDS at 3, 6, and 12 months and at 2, 3, 4, and 5 years after discharge from the intensive care unit. At each visit, patients were interviewed and examined; underwent pulmonary-function tests, the 6-minute walk test, resting and exercise oximetry, chest imaging, and a quality-of-life evaluation; and reported their use of health care services.
At 5 years, the median 6-minute walk distance was 436 m (76% of predicted distance) and the Physical Component Score on the Medical Outcomes Study 36-Item Short-Form Health Survey was 41 (mean norm score matched for age and sex, 50). With respect to this score, younger patients had a greater rate of recovery than older patients, but neither group returned to normal predicted levels of physical function at 5 years. Pulmonary function was normal to near-normal. A constellation of other physical and psychological problems developed or persisted in patients and family caregivers for up to 5 years. Patients with more coexisting illnesses incurred greater 5-year costs.
Exercise limitation, physical and psychological sequelae, decreased physical quality of life, and increased costs and use of health care services are important legacies of severe lung injury.
对于急性呼吸窘迫综合征（ARDS）幸存者的 5 年结局，仅有少数详细的面对面访谈和检查来获取随访数据。
我们在出院后 3、6 和 12 个月以及 2、3、4 和 5 年时评估了 109 例 ARDS 幸存者。在每次就诊时，患者接受访谈和检查；进行肺功能测试、6 分钟步行试验、静息和运动血氧测定、胸部影像学检查和生活质量评估；并报告其医疗保健服务的使用情况。
在 5 年时，中位 6 分钟步行距离为 436m（预测距离的 76%），医疗结局研究 36 项简短健康调查问卷的生理成分评分是 41（年龄和性别匹配的平均正常评分，50）。就该评分而言，年轻患者的恢复速度比老年患者快，但两组患者在 5 年内均未恢复到正常的生理功能预测水平。肺功能正常或接近正常。在长达 5 年的时间里，患者和家属护理人员出现了一系列其他身体和心理问题，或者这些问题持续存在。合并症较多的患者 5 年成本更高。
运动受限、身体和心理后遗症、身体质量下降、以及成本增加和医疗保健服务使用增加，是严重肺部损伤的重要遗留问题。
