Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2003 Aug;7(4):R72.
doi: 10.1186/cc2331. Epub 2003 Jul 9.

Outcome after acute respiratory failure is more dependent on dysfunction in other vital organs than on the severity of the respiratory failure

Hans Flaatten  1 , Stig Gjerde, Anne Berit Guttormsen, Oddbjørn Haugen, Tone Høivik, Henning Onarheim, Sidsel Aardal
Affiliations

Outcome after acute respiratory failure is more dependent on dysfunction in other vital organs than on the severity of the respiratory failure

Hans Flaatten et al. Crit Care. 2003 Aug.

Abstract

Introduction: The incidence and outcome of acute respiratory failure (ARF) depend on dysfunction in other organs. As a result, reported mortality in patients with ARF is derived from a mixed group of patients with different degrees of multiorgan failure. The main goal of the present study was to investigate patient outcome in single organ ARF.

Patients and method: From 1 January 2000 to 1 July 2002, all adult patients (>16 years) in the intensive care unit (ICU) at Haukeland University Hospital were scored daily using the Sequential Organ Failure Assessment (SOFA) score for organ failure. ARF was defined by the SOFA criteria: ratio of arterial oxygen tension to fractional inspired oxygen, with a value < 26.6 kPa (200 mmHg) in more than one recording during the ICU stay (SOFA score 3 or 4). Patients with ARF alone and in combination with other severe organ failure (SOFA score 3 or 4) were included. Survival was recorded on discharge from the ICU, at hospital discharge and at 90 days after ICU discharge.

Results: During the period of study, 832 adult patients were treated and 529 (63.0%) had ARF. The ICU, hospital and 3-month mortality rates were lowest in single organ ARF (3.2, 14.7 and 21.8%, respectively), with increasing mortality with each additional organ failure. When ARF occurred with four or five additional organ failures, the 3-month mortality rate was 75%. No significant differences in mortality were found between early and late ARF.

Conclusion: The prognosis for ICU patients with single organ ARF is good, both in the short and long terms. The high overall mortality rate observed is caused by dysfunction in other organs.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The main study groups shown as a flowchart, with the number and hospital mortality rates shown for each group.
Figure 2
Figure 2
Kaplan–Meier survival analysis after intensive care unit (ICU) discharge in five groups of patients with acute respiratory failure (ARF). Patients dying in the ICU are represented with survival = 0. OF, organ failure.
Figure 3
Figure 3
Arterial oxygen tension/fractional inspired oxygen (Pa O2/FiO2) ratio (kPa) shown as box plot with median values and interquartile range in the two groups of patients with acute respiratory failure (ARF) alone and ARF with other organ failure during their hospital stay (from days 1–10).
See this image and copyright information in PMC

Comment in

References

    1. Luhr O, Antonsen K, Karlsson M, Aardal S, Thorsteinsson A, Frostell C, Bonde J. Incidence and mortality after acute respiratory failure and acute respiratory distress syndrome in Sweden, Denmark, and Iceland. The ARF Study Group. Am J Respir Crit Care Med. 1998;159:1849–1861. - PubMed
    1. Estenssoro E, Dubin A, Laffaire E, Canales H, Saenz G, Moseinco M, Pozo M, Gomes A, Bardes N, Janello G. Incidence, clinical course, and outcome in 217 patients with acute respiratory distress syndrome. Crit Care Med. 2002;30:2450–2456. - PubMed
    1. Artigas A. Prognostic Factors and Outcome of ALI, Acute Lung Injury. In: Marini J, Ewans T, editor. In Acute Lung Injury. Berlin: Springer; 1998. pp. 16–38.
    1. Flaatten H, Austlid I. REGINA, developement of a database concept in intensive care medicine. Acta Anaesthesiol Scand. 1997;41:193.
    1. Le Gall J, Lemeshow S, Saulnier F. A new simplified acute physiology score (SAPS II) based on a European/North American multicenter study. JAMA. 1993;270:2957–2963. doi: 10.1001/jama.270.24.2957. - DOI - PubMed