Recovery from lung injury in survivors of acute respiratory distress syndrome: difference between pulmonary and extrapulmonary subtypes
Recovery from lung injury in survivors of acute respiratory distress syndrome: difference between pulmonary and extrapulmonary subtypes
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DOI：
10.1007/s00134-004-2374-6
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发表时间：
2004-10-01
影响因子：
38.9
通讯作者：
Koh, Y
中科院分区：
文献类型：
--
作者：
Kim, S;Oh, B;Koh, Y
目的：确定肺源性（ARDSp）和肺外源性（ARDSexp）引起的急性呼吸窘迫综合征（ARDS）的长期结局是否不同。设计：观察性研究。单位：一所大学医院的重症监护病房。患者：29例ARDS患者（16例ARDSp和13例ARDSexp），诊断后存活超过6个月。测量和结果：根据入院时的人口统计数据和严重程度指数，两组没有差异。ARDSp患者的ICU住院时间（中位21天[四分位距，12 - 43天] vs 12 [6.5 - 20]天，p = 0.097）倾向于更长，总通气时间（360 [ 96 - 700] h vs 144 [42.5 - 216] h，p = 0.045）更长。ARDSp患者在薄层计算机断层扫描（CT）上显示出更严重的异常，包括毛玻璃样阴影（GGO; 6 [ 3 - 16] vs 0 [ 0 - 2.5]，p = 0.002），网状密度（12 [ 8 - 14] vs 5 [ 2 - 9]，p = 0.033）和所有四种病变模式的总和（20 [ 11 - 27] vs 5 [ 2 - 12]，p = 0.006）。Spitzer生活质量指数和慢性呼吸问卷没有组间差异。结论：这些结果表明，ARDSp会比ARDSexp留下更严重的肺部后遗症，但其差异的临床相关性值得怀疑。
Objective: To determine whether long-term outcome differs between acute respiratory distress syndrome ( ARDS) resulting from pulmonary (ARDSp) and extrapulmonary (ARDSexp) causes. Design: Observational study. Setting: Medical intensive care unit of a university hospital. Patients: Twenty-nine ARDS patients ( 16 ARDSp and 13 ARDSexp) who survived over 6 months after diagnosis. Measurements and results: The two groups did not differ according to demographic data and severity indices on admission. The duration of ICU stay ( median 21 days [interquartile range, 12 - 43 days] vs 12 [6.5 - 20] days, p = 0.097) tended to be longer and total ventilation time ( 360 [ 96 - 700] h vs 144 [42.5 - 216] h, p = 0.045) were longer in the patients with ARDSp. The ARDSp patients showed more severe abnormalities on thin-section computed tomography (CT), including ground-glass opacity (GGO; 6 [ 3 - 16] vs 0 [ 0 - 2.5], p = 0.002), reticular density ( 12 [ 8 - 14] vs 5 [ 2 - 9], p = 0.033) and the sum of all four patterns of lesion ( 20 [ 11 - 27] vs 5 [ 2 - 12], p = 0.006). There were no between-group differences in Spitzer's Quality of Life index and the Chronic Respiratory Questionnaire. Conclusions: These results suggest that ARDSp would leave more severe lung sequelae than ARDSexp, but the clinical relevance of their difference is questionable.