PREDICTING THE PRESENCE OF PULMONARY-FUNCTION IMPAIRMENT IN ADULT-RESPIRATORY-DISTRESS-SYNDROME SURVIVORS

被引:0
作者
SUCHYTA, MR
ELLIOTT, CG
JENSEN, RL
CRAPO, RO
机构
[1] LATTER DAY ST HOSP,DEPT INTERNAL MED,DIV PULM,SHOCK TRAUMA INTERMOUNTAIN RESP INTENS CARE UNIT,SALT LAKE CITY,UT 84143
[2] UNIV UTAH,DEPT INTERNAL MED,DIV OCCUPAT PULM MED,SALT LAKE CITY,UT 84112
[3] UNIV UTAH,DEPT INTERNAL MED,DIV RESP MED,SALT LAKE CITY,UT 84112
[4] UNIV UTAH,DEPT INTERNAL MED,DIV CRIT CARE MED,SALT LAKE CITY,UT 84112
关键词
PULMONARY FUNCTION; ADULT RESPIRATORY DISTRESS SYNDROME;
D O I
暂无
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Varying degrees of impairment in pulmonary function in survivors of adult respiratory distress syndrome (ARDS) have been reported. Physiologic indices of the severity of disease have been associated with impaired pulmonary function after ARDS, including duration of exposure to FI(O2) > 0.6, AaD(O2) maximal mean pulmonary artery pressure, lowest total static thoracic compliance, and peak airway pressure. Prediction of impairment following ARDS is difficult because clinical observations may reflect reversible lung injury (e.g. lung edema) and clinical features of ARDS do not predict subsequent function reliably. We developed a severity score to predict the presence of impairment of pulmonary function in 51 ARDS survivors, by examining the following clinical variables: (1) predisposing factor for ARDS; (2) age; (3) sex; (4) severity of hypoxemia; (5) smoking history; (6) number of days of positive pressure ventilation; (7) lowest total static thoracic compliance; (8) maximal mean pulmonary artery pressure, and (9) presence of barotrauma. Pulmonary function studies were performed at least 1 year after ARDS onset. The ARDS(score) developed required only two variables: ARDS(score) = duration of positive pressure ventilation (days) minus lowest static thoracic compliance (ml/cm H2O). Significant correlations (p < 0.001) were found between linear regressions of percent predicted FEV1, FVC, TLC and DL(CO) against ARDS(score). ARDS(score) > + 20 predicted an 82% probability of impaired FEV1, FVC or TLC and a 100% probability of an impaired DL(CO). We conclude that a score based upon duration of positive pressure ventilation and lowest static thoracic compliance predicts impaired pulmonary function more than 1 year after ARDS.
引用
收藏
页码:103 / 108
页数:6
相关论文
共 28 条
[1]  
BACHOFEN M, 1976, AM REV RESPIR DIS, V113, P7
[2]  
BURTON GG, 1991, RESPIRATORY CARE GUI, P176
[3]   VARIABILITY IN LUNG COLLAGEN AMOUNTS AFTER PROLONGED SUPPORT OF ACUTE RESPIRATORY-FAILURE [J].
COLLINS, JF ;
SMITH, JD ;
COALSON, JJ ;
JOHANSON, WG .
CHEST, 1984, 85 (05) :641-646
[4]  
CRAPO RO, 1981, AM REV RESPIR DIS, V123, P185
[5]  
CRAPO RO, 1981, AM REV RESPIR DIS, V123, P659
[6]  
DREYFUSS D, 1985, AM REV RESPIR DIS, V132, P880
[7]  
EAST TD, 1990, 14TH P ANN S COMP AP, P563
[8]  
ELLIOTT CG, 1987, AM REV RESPIR DIS, V135, P634
[9]  
ELLIOTT CG, 1990, CLIN CHEST MED, V11, P789
[10]  
ELLIOTT CG, 1983, AM REV RESPIR DIS, V123, P492