AN EARLY TEST OF SURVIVAL IN PATIENTS WITH THE ADULT RESPIRATORY-DISTRESS SYNDROME - THE PAO2/FLO2 RATIO AND ITS DIFFERENTIAL RESPONSE TO CONVENTIONAL THERAPY
AN EARLY TEST OF SURVIVAL IN PATIENTS WITH THE ADULT RESPIRATORY-DISTRESS SYNDROME - THE PAO2/FLO2 RATIO AND ITS DIFFERENTIAL RESPONSE TO CONVENTIONAL THERAPY
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DOI：
10.1378/chest.96.4.849
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发表时间：
1989-10-01
期刊：
影响因子：
9.6
通讯作者：
URSPRUNG, JJ
中科院分区：
文献类型：
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作者：
BONE, RC;MAUNDER, R;URSPRUNG, JJ
成人呼吸窘迫综合征（ARDS）患者的死亡率超过50%。我们在一项大型多中心研究的安慰剂组中分析了低氧血症的程度，表现为PaO 2/FIO 2比值及其对常规治疗的早期反应，包括呼气末正压（PEEP）。在诊断ARDS时，存活患者与随后死亡患者的PaO 2/FIO 2比值无差异。经过一天的常规治疗，包括PEEP，那些幸存的患者增加了他们的PaO 2/FIO 2比值。在7天的疗程中，死亡者没有改善。在7天的观察期内，PaO 2/FIO 2比值的差异显著。我们的结论是，对传统治疗的早期反应选择了预后良好的患者群体，并且可以用作对ARDS可能生存的测试。
Patients with established adult respiratory distress syndrome (ARDS) have a mortality rate that exceeds 50 percent. We analyzed the magnitude of hypoxemia as manifest by the PaO2/FIO2 ratio and its early response to conventional therapy including positive end-expiratory pressure (PEEP) in the placebo group of a large multicenter study. The PaO2/FIO2 ratio was not different at the time of diagnosis of ARDS in those patients who lived compared to those who subsequently died. After one day of conventional therapy including PEEP, those patients who survived increased their PaO2/FIO2 ratio. The nonsurvivors did not improve over a seven-day course. The difference in the PaO2/FIO2 ratio was significant throughout the seven-day observation period. We conclude that the early response to conventional therapy picks a patient population with a good prognosis and can be used as a test of likely survival from ARDS.