2011 OPEN FORUM Abstracts
COMPARISON OF CLINICAL OUTCOME IN PATIENTS WITH PULMONARY ARDS AND EXTRAPULMONARY ARDS.
Ramandeep Kaur1, Anitha Shenoy2; 1Respiratory Care, Rush University Medical Centre, Chicago, IL; 2Anesthesiology, Manipal University, Manipal, India
INTRODUCTION The American- European Conference Consensus held in 1994 described two discrete etiological pathways leading to Acute Respiratory Distress Syndrome (ARDS): direct/pulmonary and indirect/extrapulmonary causes. These two forms of ARDS differ in radiological appearance , respiratory mechanics and in response to different mechanical ventilation strategies like PEEP therapy, alveolar recruitment and prone position. The purpose of this study was to investigate if the etiological difference in these two forms of ARDS has any effect on the clinical outcome of the patients with pulmonary and extrapulmonary ARDS. MATERIAL AND METHODS 51 patients were enrolled into the study in a tertiary hospital in India, out of which 15 patients were diagnosed with pulmonary ARDS and 36 with extrapulmonary ARDS. The etiology of ARDS was ascertained on the basis of medical history, physical examination, chest radiography and lab investigations. Among pulmonary ARDS patients, bacterial pneumonia was the most common cause whereas the most patients with extrapulmonary ARDS had sepsis. All patients received mechanical ventilation using the protocol followed by ARDS Network low tidal volume ventilation strategy. Statistical analyses was performed using a statistical software package(SPSS). Descriptive frequencies were expressed using the mean (SD) and the median (range and interquartile range, IQR). Level of significance were expressed as p value and odds ratios (ORs) [95% confidence intervals (CIs)] RESULTS There were 33 males and 18 females in the study, with a mean age of 43 ± 19 years. At ICU admission, patients with extrapulmonary ARDS were young and sicker than those with pulmonary ARDS but there was no difference in the PaO2/ FiO2 score or static compliance between both the groups. Also, there was no difference in hospital survival between the two categories of ARDS patients (p < 0.05) CONCLUSION Within the limitations of being a small group study, the category of lung injury did not influence the length of ICU stay or the ultimate survival rate between both the groups and this study has shown that the etiological factor has no influence over the ARDS mortality. Sponsored Research - None