Acute Respiratory Distress Syndrome: Case Series, Two Years at an Intensive Care Unit
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4266 |
Resumo: | Introduction: Acute Respiratory Distress Syndrome has a significant incidence and mortality at Intensive Care Units. Therefore, more studies are necessary in order to develop new effective therapeutic strategies. The authors have proposed themselves to characterize Acute Respiratory Distress Syndrome patients admitted to an Intensive Care Unit for 2 years.Material and Methods: This was an observational retrospective study of the patients filling the Acute Respiratory Distress Syndrome criteria from the American-European Consensus Conference on ARDS, being excluded those non invasively ventilated. Demographic data, Acute Respiratory Distress Syndrome etiology, comorbidities, Gravity Indices, PaO2/FiO2, ventilator modalities and programmation, pulmonary compliance, days of invasive mechanical ventilation, corticosteroids use, rescue therapies, complications, days atIntensive Care Unit and obits were searched for and were submitted to statistic description and analysis.Results: A 40 patients sample was obtained, with a median age of 72.5 years (interquartile range = 22) and a female:male ratio of ≈1:1.86. Fifty five percent of the Acute Respiratory Distress Syndrome cases had pulmonary etiology. The mean minimal PaO2/FiO2 was 88mmHg (CI 95%: 78.5–97.6). The mean maximal applied PEEP was 12.4 cmH2O (Standard Deviation 4.12) and the mean maximal used tidal volume was 8.2 mL/ Kg ideal body weight (CI 95%: 7.7–8.6). The median invasive mechanical ventilation days was 10. Forty seven and one half percent of the patients had been administered corticosteroids and 52.5% had been submitted to recruitment maneuvers. The most frequent complication was Ventilator Associated Pneumonia (20%). The median Intensive Care Unit stay was 10.7 days (interquartile range 10.85). The fatality rate was 60%. The probability of the favorable outcome ‘non-death in Intensive Care Unit’ was 4.4x superior for patients who were administered corticosteroids and 11x superior for patients < 65 years old.Discussion and Conclusions: Acute Respiratory Distress Syndrome is associated with long hospitalization and significant mortality. New prospective studies will be necessary to endorse the potential benefit of steroid therapy and to identify the subgroups of patients that warrant its use. |
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Acute Respiratory Distress Syndrome: Case Series, Two Years at an Intensive Care UnitSíndrome de Dificuldade Respiratória Aguda: Casuística de Dois Anos numa Unidade de Cuidados IntensivosIntroduction: Acute Respiratory Distress Syndrome has a significant incidence and mortality at Intensive Care Units. Therefore, more studies are necessary in order to develop new effective therapeutic strategies. The authors have proposed themselves to characterize Acute Respiratory Distress Syndrome patients admitted to an Intensive Care Unit for 2 years.Material and Methods: This was an observational retrospective study of the patients filling the Acute Respiratory Distress Syndrome criteria from the American-European Consensus Conference on ARDS, being excluded those non invasively ventilated. Demographic data, Acute Respiratory Distress Syndrome etiology, comorbidities, Gravity Indices, PaO2/FiO2, ventilator modalities and programmation, pulmonary compliance, days of invasive mechanical ventilation, corticosteroids use, rescue therapies, complications, days atIntensive Care Unit and obits were searched for and were submitted to statistic description and analysis.Results: A 40 patients sample was obtained, with a median age of 72.5 years (interquartile range = 22) and a female:male ratio of ≈1:1.86. Fifty five percent of the Acute Respiratory Distress Syndrome cases had pulmonary etiology. The mean minimal PaO2/FiO2 was 88mmHg (CI 95%: 78.5–97.6). The mean maximal applied PEEP was 12.4 cmH2O (Standard Deviation 4.12) and the mean maximal used tidal volume was 8.2 mL/ Kg ideal body weight (CI 95%: 7.7–8.6). The median invasive mechanical ventilation days was 10. Forty seven and one half percent of the patients had been administered corticosteroids and 52.5% had been submitted to recruitment maneuvers. The most frequent complication was Ventilator Associated Pneumonia (20%). The median Intensive Care Unit stay was 10.7 days (interquartile range 10.85). The fatality rate was 60%. The probability of the favorable outcome ‘non-death in Intensive Care Unit’ was 4.4x superior for patients who were administered corticosteroids and 11x superior for patients < 65 years old.Discussion and Conclusions: Acute Respiratory Distress Syndrome is associated with long hospitalization and significant mortality. New prospective studies will be necessary to endorse the potential benefit of steroid therapy and to identify the subgroups of patients that warrant its use.Introdução: A Síndrome de Dificuldade Respiratória Aguda apresenta incidência e mortalidade significativas em Cuidados Intensivos, justificando estudos adicionais, nomeadamente para definição de novas abordagens terapêuticas. Os autores propuseram-se caracterizaros casos duma Unidade de Cuidados Intensivos em dois anos.Material e Métodos: Procedeu-se a um estudo observacional retrospectivo dos casos admitidos numa Unidade de Cuidados Intensivos, cumprindo os critérios diagnósticos da American-European Consensus Conference on ARDS, tendo sido excluídos os não ventilados invasivamente. Pesquisados e submetidos a tratamento estatístico: dados demográficos, etiologia do Síndrome de Dificuldade Respiratória Aguda, comorbilidades, Índices de Gravidade, PaO2/FiO2, modalidades e parâmetros ventilatórios, compliance pulmonar, dias de ventilação mecânica invasiva, corticoterapia, terapêuticas de resgate, complicações, duração do internamento, óbitos.Resultados: Obtiveram-se 40 doentes, com uma mediana de 72,5 anos (amplitude interquartil 22) e um ratio feminino:masculino ≈1:1,86. Cinquenta e cinco por cento dos Síndrome de Dificuldade Respiratória Aguda tiveram etiologia pulmonar. A média do PaO2/ FiO2 mínimo foi 88mm Hg (IC 95%: 78,5-97,6). A média da PEEP máxima aplicada foi 12,4 cmH2O (Desvio Padrão 4,12) e a médiado Volume Corrente máximo utilizado foi 8,2 mL/Kg peso ideal (IC 95%: 7,7-8,6). A mediana dos dias de ventilação mecânica invasiva foi 10. Em 47,5% dos doentes foram administrados corticóides. Em 52,5% foi executado recrutamento alveolar. A complicação mais frequente foi a Pneumonia Associada a Ventilação (20%). A mediana da duração do internamento foi 10,7 dias (amplitude interquartil10,85). Faleceram 60% dos doentes. A probabilidade de outcome favorável ‘não óbito na Unidade de Cuidados Intensivos’ foi 4,4x superior nos doentes sob corticoterapia e 11x superior nos doentes com idade < 65 anos.Discussão e Conclusões: A Síndrome de Dificuldade Respiratória Aguda associa-se a internamentos prolongados e significativa mortalidade. Novos estudos prospectivos serão necessários para confirmar o benefício dos corticóides, bem como identificar o/(s) subgrupo/(s) de doentes que mais justificam a sua utilização.Ordem dos Médicos2014-04-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4266oai:ojs.www.actamedicaportuguesa.com:article/4266Acta Médica Portuguesa; Vol. 27 No. 2 (2014): March-April; 211-217Acta Médica Portuguesa; Vol. 27 N.º 2 (2014): Março-Abril; 211-2171646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4266https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4266/3953https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4266/4117https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4266/7185Taborda, LúciaBarros, FilipaFonseca, VitorIrimia, ManuelCarvalho, RamiroDiogo, CláudiaRamos, Armindoinfo:eu-repo/semantics/openAccess2022-12-20T11:03:31Zoai:ojs.www.actamedicaportuguesa.com:article/4266Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:18:46.736508Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Acute Respiratory Distress Syndrome: Case Series, Two Years at an Intensive Care Unit Síndrome de Dificuldade Respiratória Aguda: Casuística de Dois Anos numa Unidade de Cuidados Intensivos |
title |
Acute Respiratory Distress Syndrome: Case Series, Two Years at an Intensive Care Unit |
spellingShingle |
Acute Respiratory Distress Syndrome: Case Series, Two Years at an Intensive Care Unit Taborda, Lúcia |
title_short |
Acute Respiratory Distress Syndrome: Case Series, Two Years at an Intensive Care Unit |
title_full |
Acute Respiratory Distress Syndrome: Case Series, Two Years at an Intensive Care Unit |
title_fullStr |
Acute Respiratory Distress Syndrome: Case Series, Two Years at an Intensive Care Unit |
title_full_unstemmed |
Acute Respiratory Distress Syndrome: Case Series, Two Years at an Intensive Care Unit |
title_sort |
Acute Respiratory Distress Syndrome: Case Series, Two Years at an Intensive Care Unit |
author |
Taborda, Lúcia |
author_facet |
Taborda, Lúcia Barros, Filipa Fonseca, Vitor Irimia, Manuel Carvalho, Ramiro Diogo, Cláudia Ramos, Armindo |
author_role |
author |
author2 |
Barros, Filipa Fonseca, Vitor Irimia, Manuel Carvalho, Ramiro Diogo, Cláudia Ramos, Armindo |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Taborda, Lúcia Barros, Filipa Fonseca, Vitor Irimia, Manuel Carvalho, Ramiro Diogo, Cláudia Ramos, Armindo |
description |
Introduction: Acute Respiratory Distress Syndrome has a significant incidence and mortality at Intensive Care Units. Therefore, more studies are necessary in order to develop new effective therapeutic strategies. The authors have proposed themselves to characterize Acute Respiratory Distress Syndrome patients admitted to an Intensive Care Unit for 2 years.Material and Methods: This was an observational retrospective study of the patients filling the Acute Respiratory Distress Syndrome criteria from the American-European Consensus Conference on ARDS, being excluded those non invasively ventilated. Demographic data, Acute Respiratory Distress Syndrome etiology, comorbidities, Gravity Indices, PaO2/FiO2, ventilator modalities and programmation, pulmonary compliance, days of invasive mechanical ventilation, corticosteroids use, rescue therapies, complications, days atIntensive Care Unit and obits were searched for and were submitted to statistic description and analysis.Results: A 40 patients sample was obtained, with a median age of 72.5 years (interquartile range = 22) and a female:male ratio of ≈1:1.86. Fifty five percent of the Acute Respiratory Distress Syndrome cases had pulmonary etiology. The mean minimal PaO2/FiO2 was 88mmHg (CI 95%: 78.5–97.6). The mean maximal applied PEEP was 12.4 cmH2O (Standard Deviation 4.12) and the mean maximal used tidal volume was 8.2 mL/ Kg ideal body weight (CI 95%: 7.7–8.6). The median invasive mechanical ventilation days was 10. Forty seven and one half percent of the patients had been administered corticosteroids and 52.5% had been submitted to recruitment maneuvers. The most frequent complication was Ventilator Associated Pneumonia (20%). The median Intensive Care Unit stay was 10.7 days (interquartile range 10.85). The fatality rate was 60%. The probability of the favorable outcome ‘non-death in Intensive Care Unit’ was 4.4x superior for patients who were administered corticosteroids and 11x superior for patients < 65 years old.Discussion and Conclusions: Acute Respiratory Distress Syndrome is associated with long hospitalization and significant mortality. New prospective studies will be necessary to endorse the potential benefit of steroid therapy and to identify the subgroups of patients that warrant its use. |
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2014 |
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2014-04-30 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4266 oai:ojs.www.actamedicaportuguesa.com:article/4266 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4266 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4266 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4266/3953 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4266/4117 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4266/7185 |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 27 No. 2 (2014): March-April; 211-217 Acta Médica Portuguesa; Vol. 27 N.º 2 (2014): Março-Abril; 211-217 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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