Aspirin therapy in patients with acute respiratory distress syndrome (ARDS) is associated with reduced intensive care unit mortality: a prospective analysis.
Aspirin therapy in patients with acute respiratory distress syndrome (ARDS) is associated with reduced intensive care unit mortality: a prospective analysis.
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DOI：
10.1186/s13054-015-0846-4
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发表时间：
2015-03-23
期刊：
影响因子：
--
通讯作者：
McAuley DF
中科院分区：
文献类型：
--
作者：
Boyle AJ;Di Gangi S;Hamid UI;Mottram LJ;McNamee L;White G;Cross LJ;McNamee JJ;O'Kane CM;McAuley DF
急性呼吸窘迫综合征（Acute respiratory distress syndrome， ARDS）是一种常见的高死亡率和长期发病率的临床综合征。迄今为止尚无有效的药物治疗方法。阿司匹林治疗最近已被证明可降低发生ARDS的风险，但阿司匹林对已发生ARDS的影响尚不清楚。2010年12月至2012年7月，在一个大型区域内科和外科ICU中，前瞻性识别所有ARDS患者，并回顾性记录人口统计学、临床和实验室变量。包括院前和重症监护病房（ICU）住院期间阿司匹林的使用情况。主要终点是ICU死亡率。我们使用单变量和多变量逻辑回归分析来评估这些变量对ICU死亡率的影响。共纳入202例ARDS患者；其中56人（28%）在院前、ICU或两者同时服用阿司匹林。通过多因素logistic回归分析，在住院前或住院期间给予阿司匹林治疗与ICU死亡率降低相关（优势比（or） 0.38 (0.15 ~ 0.96) P = 0.04）。预测ARDS患者ICU死亡率的其他因素是血管加压素使用（OR 2.09 (1.05 ~ 4.18) P = 0.04）和APACHE II评分（OR 1.07 (1.02 ~ 1.13) P = 0.01）。对ICU住院时间和住院死亡率没有影响。阿司匹林治疗与ICU死亡风险降低相关。这些数据首次证明阿司匹林对急性呼吸窘迫综合征患者具有潜在的保护作用。需要临床试验来评估阿司匹林作为ARDS药物干预的作用。
Acute respiratory distress syndrome (ARDS) is a common clinical syndrome with high mortality and long-term morbidity. To date there is no effective pharmacological therapy. Aspirin therapy has recently been shown to reduce the risk of developing ARDS, but the effect of aspirin on established ARDS is unknown. In a single large regional medical and surgical ICU between December 2010 and July 2012, all patients with ARDS were prospectively identified and demographic, clinical, and laboratory variables were recorded retrospectively. Aspirin usage, both pre-hospital and during intensive care unit (ICU) stay, was included. The primary outcome was ICU mortality. We used univariate and multivariate logistic regression analyses to assess the impact of these variables on ICU mortality. In total, 202 patients with ARDS were included; 56 (28%) of these received aspirin either pre-hospital, in the ICU, or both. Using multivariate logistic regression analysis, aspirin therapy, given either before or during hospital stay, was associated with a reduction in ICU mortality (odds ratio (OR) 0.38 (0.15 to 0.96) P = 0.04). Additional factors that predicted ICU mortality for patients with ARDS were vasopressor use (OR 2.09 (1.05 to 4.18) P = 0.04) and APACHE II score (OR 1.07 (1.02 to 1.13) P = 0.01). There was no effect upon ICU length of stay or hospital mortality. Aspirin therapy was associated with a reduced risk of ICU mortality. These data are the first to demonstrate a potential protective role for aspirin in patients with ARDS. Clinical trials to evaluate the role of aspirin as a pharmacological intervention for ARDS are needed.
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影响因子：
10
作者：
Perkins, G. D.;Nathani, N.;Thickett, D. R.
通讯作者：
Thickett, D. R.
影响因子：
8.8
作者：
Abraham, E
通讯作者：
Abraham, E
影响因子：
3.1
作者：
Bates, JJ;Watson, RWG;Buggy, DJ
通讯作者：
Buggy, DJ
院前他汀类药物和阿司匹林使用以及严重败血症和急性肺损伤/急性呼吸窘迫综合征的患病率。
影响因子：
8.8
作者：
O'Neal HR Jr;Koyama T;Koehler EA;Siew E;Curtis BR;Fremont RD;May AK;Bernard GR;Ware LB
通讯作者：
Ware LB
影响因子：
8
作者：
通讯作者：
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