Acute lung injury: surprisingly common in the neurologic intensive care unit.
Acute lung injury: surprisingly common in the neurologic intensive care unit.
复制标题
急性肺损伤：在神经重症监护病房中非常常见。
DOI：
10.1097/ccm.0b013e31823878d9
复制
发表时间：
2012
影响因子：
8.8
通讯作者：
Girard,TimothyD
中科院分区：
文献类型：
--
作者：
Ware,LorraineB;Girard,TimothyD
Acute lung injury and the acute respiratory distress syndrome (ALI/ARDS) are syndromes of acute respiratory failure that most commonly occur in the setting of severe sepsis, pneumonia, or severe traumatic injuries (1). Patients with critical neurologic disorders have therefore not been well represented in investigations of risk factors for ALI/ARDS, which have focused largely on patients admitted to medical, surgical, or trauma intensive care units (ICUs)(2). Clinical trials of interventions for ALI/ARDS have also typically excluded patients with acute neurologic illness (4). As dedicated neurologic critical care units staffed by neurointensivists become more common, there is a real and growing need to better understand the incidence and risk factors for ALI/ARDS among patients with neurologic critical illness. In this issue of Critical Care Medicine, Hoesch and colleagues (5) report the incidence of and risk factors for ALI/ARDS in a cohort of systemically evaluated patients who were mechanically ventilated for 48 hrs in the neurologic ICU at a large, academic medical center. Remarkably, over one third (68 of the 192 patients in the study) met stringent diagnostic criteria for ALI/ARDS, suggesting that ALI/ARDS is one of the more common non-neurologic diagnoses encountered in the neurologic ICU setting.Over a 3-yr period, Hoesch et al prospectively evaluated 192 consecutive patients who met eligibility requirements using a thorough diagnostic algorithm to identify patients with ALI/ARDS. Specifically, those with bilateral infiltrates on chest radiograph and PaO2/FIO2 ratios 200 or 300
