Lakhey S, Shrestha R, Thapa S, Tuladhar S
Departmant of Medicine, B & B Hospital, Gwarko Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2010 Apr-Jun;49(178):129-32.
Acute respiratory distress syndrome (ARDS) is an acute hypoxic respiratory failure due to non-cardiogenic pulmonary edema with diverse etiologies and high mortality. This study has been conducted to assess etiologies, physiological variables, mortality and its predictors in the ICU.
A prospective cross-sectional study was carried out with all the patients more than 14 years of age admitted to ICU of a general hospital that fulfilled the criteria of American-European Consensus Conference criteria for ARDS were included in the study.
Out of total 42 patients, main etiologies were sepsis (30.7%), polytrauma (25%), fat embolism syndrome (25%), acute severe pancreatitis (5.7%) pneumonia (5.7%) and others (8.3%). Non-survivors had significantly lower pH, PaO2/FiO2 on day 3 and higher SOFA score. Hospital mortality was 38.9%. The causes of death were MOF (57.1%), septic shock (21.4%) and refractory hypoxaemia (21.4%). Factors significantly associated with mortality were PaO2/FiO2 on day 3, pH and SOFA score; and SOFA score of 13 or above was predictive of death.
MOF was the most common cause of death. Sepsis was the most common etiology. ARDS was associated with high but comparable mortality. The non-survivors had significantly lower oxygenation, pH, and higher SOFA scores.
急性呼吸窘迫综合征（ARDS）是一种由于非心源性肺水肿导致的急性低氧性呼吸衰竭，病因多样，死亡率高。本研究旨在评估重症监护病房（ICU）中的病因、生理变量、死亡率及其预测因素。
对一家综合医院ICU收治的所有14岁以上符合欧美共识会议ARDS标准的患者进行了一项前瞻性横断面研究。
在总共42例患者中，主要病因包括败血症（30.7%）、多发伤（25%）、脂肪栓塞综合征（25%）、急性重症胰腺炎（5.7%）、肺炎（5.7%）和其他（8.3%）。非幸存者在第3天的pH值、动脉血氧分压/吸入氧分数值（PaO2/FiO2）显著更低，序贯器官衰竭评估（SOFA）评分更高。医院死亡率为38.9%。死亡原因包括多器官功能衰竭（MOF，57.1%）、感染性休克（21.4%）和难治性低氧血症（21.4%）。与死亡率显著相关的因素为第3天的PaO2/FiO2、pH值和SOFA评分；SOFA评分为13分及以上可预测死亡。
MOF是最常见的死亡原因。败血症是最常见的病因。ARDS死亡率高但具有可比性。非幸存者的氧合、pH值显著更低，SOFA评分更高。
