Scenario of acute respiratory distress syndrome in a tertiary care center

Abstract

Introduction: Acute respiratory distress syndrome (ARDS) is an acute hypoxic respiratory failure due to non-cardiogenic pulmonary edema with diverse etiologies and high mortality. This study has been conducted to assess etiologies, physiological variables, mortality and its predictors in the ICU.

Methods: A prospective cross-sectional study was carried out with all the patients more than 14 years of age admitted to ICU of a general hospital that fulfilled the criteria of American-European Consensus Conference criteria for ARDS were included in the study.

Results: Out of total 42 patients, main etiologies were sepsis (30.7%), polytrauma (25%), fat embolism syndrome (25%), acute severe pancreatitis (5.7%) pneumonia (5.7%) and others (8.3%). Non-survivors had significantly lower pH, PaO2/FiO2 on day 3 and higher SOFA score. Hospital mortality was 38.9%. The causes of death were MOF (57.1%), septic shock (21.4%) and refractory hypoxaemia (21.4%). Factors significantly associated with mortality were PaO2/FiO2 on day 3, pH and SOFA score; and SOFA score of 13 or above was predictive of death.

Conclusions: MOF was the most common cause of death. Sepsis was the most common etiology. ARDS was associated with high but comparable mortality. The non-survivors had significantly lower oxygenation, pH, and higher SOFA scores.