An analysis of patients followed up in the intensive care unit with the diagnosis of acute respiratory distress syndrome

Abstract

Objective: To examine the factors thought to have an effect on the mortality of patients with acute respiratory distress syndrome (ARDS) in the intensive care unit (ICU). Methods: A retrospective evaluation of 100 patients diagnosed with ARDS in the ICU between January 2009 and January 2013 was made. Surviving and deceased patients were compared with respect to the effect of the general characteristics, aetiological and prognostic factors, mechanical ventilation (MV) applications (especially permissive hypercapnia resulting from the restriction of the tidal volume predicted to avoid excessive distention of the alveoli), laboratory test values, multiorgan dysfunction rates, Acute Physiologic Assessment and Chronic Health Eval­uation II score, Lung Injury Score, Glasgow Coma Score, Sequential Organ Failure Assessment scores, arterial blood gas parameters and partial pressure of arterial oxygen/fraction of inspired oxygen ratio values on mortality. Results: There were 100 patients with ARDS comprising 61 males and 39 females with a mean age of 57.0±13.0 (range: 20-82) years and length of stay in the ICU of 38.7±13 days. The aetiological causes of ARDS were determined as pneumonia in 37 patients, trauma (traffic acci­dents inside or outside the vehicle and other accidents) in 14, sepsis in 19, pulmonary contusion in 9, non-pulmonary infection in 6, intoxication in 5, multiple blood transfusions in 4, firearms injury in 4 and acute pancreatitis in 2. Forty-four patients died. Conclusion: Survival rates were increased in patients with ARDS with early diagnosis and ICU support, lung protective MV strategy and permissive hypercapnia.