ARDS in patients with thermal injury
ARDS in patients with thermal injury
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DOI：
10.1007/pl00003763
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发表时间：
1999-11-01
影响因子：
38.9
通讯作者：
Stewart, TE
中科院分区：
文献类型：
--
作者：
Dancey, DR;Hayes, J;Stewart, TE
目的：探讨烧伤机械通气患者发生成人呼吸窘迫综合征（ARDS）的时间。其次，要考虑烧伤相关的危险因素，人口统计学，发病率和死亡率的ARDS在这个population.Design：回顾性图表审查; ARDS定义根据美国-欧洲共识会议和肺损伤严重程度评分的定义。1991年1月1日至1995年2月28日期间收治的需要机械通气的热损伤患者。干预措施：无。测量和结果：在469例连续住院患者中，126例（26.9%）接受了插管和机械通气。根据美国-欧洲共识和肺损伤严重程度评分（评分> 2.5）定义ARDS。根据美国-欧洲共识和肺损伤严重程度评分定义，从进入烧伤病房到ARDS发作的平均时间分别为6.9 +/- 5.2和8.2 +/- 10.7天（p = 0.41）。根据美国-欧洲共识和肺损伤严重程度评分定义，插管患者中分别有53.6%和45.2%发生了ARDS（p = 0.19）。使用多变量logistic分析，只有年龄被证明是一个独立的危险因素，发展为ARDS（p = 0.03），虽然有一个趋势，增加吸入性损伤的发病率在ARDS患者。死亡率并没有显着更大（41.8比32.2%），在那些与ARDS相比，那些没有（p = 0.27）。结论：根据美国-欧洲共识会议和肺损伤严重程度评分的定义，ARDS是常见的成人烧伤人群，并有一个延迟发作相比，大多数重症监护人群。我们发现年龄是ARDS的主要诱发因素。
Objective:To determine the time to onset of the adult respiratory distress syndrome (ARDS) in patients with thermal injury requiring mechanical ventilation. Secondarily, to consider the burn-related risk factors, demographics, incidence, and mortality for ARDS in this population.Design: Retrospective chart review; ARDS defined according to the American-European Consensus Conference and the Lung Injury Severity Score definitions.Setting: Regional, tertiary referral, adult burn unit in a university teaching hospital.Patients and participants: Patients with thermal injury requiring mechanical ventilation, admitted between 1 January 1991 and 28 February 1995.Interventions: None.Measurements and results: Of 469 consecutive admissions, 126 (26.9%) received intubation and mechanical ventilation. ARDS was defined according to the American-European Consensus and Lung Injury Severity Score (score > 2.5) definitions. The mean time to onset of ARDS from admission to the burn unit was 6.9 +/- 5.2 and 8.2 +/- 10.7 days when defined by the American-European Consensus and Lung Injury Severity Score definitions respectively (p = 0.41). Of the intubated patients, 53.6 and 45.2% developed ARDS according to the American-European Consensus and Lung Injury Severity Score definitions, respectively (p = 0.19). Using multivariate logistic analysis, only age proved to be an independent risk factor for the development of ARDS (p = 0.03), although there was a trend toward an increased incidence of inhalation injury in patients with ARDS. Mortality was not significantly greater (41.8 vs 32.2%) in those with ARDS compared to those without (p = 0.27).Conclusions: According to the American-European Consensus Conference and the Lung Injury Severity Score definitions, ARDS is common in the adult burn population and has a delayed onset compared to most critical care populations. We found age to be a major predisposing factor for ARDS.