Many Acute Respiratory Distress Syndrome Cases are Going Underrecognized
HealthDay News — The period prevalence of acute respiratory distress syndrome (ARDS) is 10.4% in intensive care unit (ICU) admissions, according to a study published online February 22 in the Journal of the American Medical Association to coincide with the Society of Critical Care Medicine's 45th Critical Care Congress, held from February 20 to 24 in Orlando, Florida.
Giacomo Bellani, MD, PhD, from the University of Milan-Bicocca in Italy, and colleagues examined ICU incidence and outcome of ARDS in a multicenter prospective cohort study. Participants were undergoing invasive or noninvasive ventilation in a convenience sample of 459 ICUs from 50 countries across five continents.
The researchers found that 3,022 (10.4%) of the 29,144 patients admitted to participating ICUs fulfilled the criteria for ARDS. Of these, 2,377 patients developed ARDS within the first 48 hours and underwent management of respiratory failure with invasive mechanical ventilation. The period prevalence of mild, moderate, and severe ARDS was 30.0, 46.6, and 23.4%, respectively. Clinical recognition of ARDS varied from 51.3 to 78.5% in mild and severe ARDS, respectively. Clinical recognition of ARDS correlated with higher positive end-expository pressure, greater use of neuromuscular blockade, and prone positioning. For mild, moderate, and severe ARDS, hospital mortality was 34.9, 40.3, and 46.1%, respectively.
"These findings indicate the potential for improvement in the management of patients with ARDS," the authors write.