دورية أكاديمية
Acute respiratory distress syndrome mimickers lacking common risk factors of the Berlin definition
| العنوان: | Acute respiratory distress syndrome mimickers lacking common risk factors of the Berlin definition |
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| المؤلفون: | Gibelin, Aude, Parrot, Antoine, Maitre, Bernard, Brun-Buisson, Christian, Mekontso Dessap, Armand, Fartoukh, Muriel, de Prost, Nicolas |
| المساهمون: | CHU Tenon AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Pôle Thorax Voies aériennes, Groupe Hospitalier des Hôpitaux Universitaires de l’Est Parisien, Université Pierre et Marie Curie - Paris 6 (UPMC), Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Collégium Gallilée, Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12) |
| المصدر: | ISSN: 0342-4642. |
| بيانات النشر: | HAL CCSD Springer Verlag |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Respiratory distress syndrome adult, Pulmonary edema, Respiration, artificial, Lung diseases, Idiopathic pulmonary fibrosis, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract |
| الوصف: | International audience ; PurposeSome patients presenting with acute respiratory failure and meeting the Berlin criteria for acute respiratory distress syndrome (ARDS) lack exposure to common risk factors (CRF). These so-called ARDS mimickers often lack histological diffuse alveolar damage. We aimed to describe such ARDS mimickers lacking CRF (ARDSCRF−) in comparison with others (ARDSCRF+).MethodsRetrospective study including all patients receiving invasive mechanical ventilation for ARDS admitted to the intensive care units (ICUs) of two tertiary care centers from January 2003 to December 2012.ResultsThe prevalence of ARDSCRF− was 7.5 % (95 % CI [5.5–9.5]; n = 50/665). On the basis of medical history, bronchoalveolar lavage fluid cytology, and chest CT scan patterns, four etiological categories were identified: immune (n = 18; 36 %), drug-induced (n = 13; 26 %), malignant (n = 7; 14 %), and idiopathic (n = 12; 24 %). Although the ARDSCRF− patients had a lower logistic organ dysfunction score (4 [3–8] vs. 10 [6–13]; p < 0.0001) and less often shock upon ICU admission (44 vs. 80 %; p < 0.0001) than their counterparts, their overall ICU mortality rate was very high (66 % [46–74]), and the absence of CRF remained associated with ICU mortality by multivariable logistic regression analysis (adjusted OR = 2.06; 95 % CI [1.02–4.18]; p = 0.044). Among ARDSCRF− patients, the presence of potentially reversible lung lesions with corticosteroids (aOR = 0.14; 95 % CI [0.03–0.62]) was associated with ICU survival.ConclusionsThe absence of CRF among patients with ARDS is common and associated with a higher risk of mortality. For such atypical ARDS, a complete diagnostic workup, including bronchoalveolar lavage fluid cytology and chest CT scan patterns, should be performed to identify those patients who might benefit from specific therapies, including corticosteroids. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | hal-01288664; https://hal.sorbonne-universite.fr/hal-01288664Test; https://hal.sorbonne-universite.fr/hal-01288664/documentTest; https://hal.sorbonne-universite.fr/hal-01288664/file/Gibelin_2016_Acute_respiratory.pdfTest |
| DOI: | 10.1007/s00134-015-4064-y |
| الإتاحة: | https://doi.org/10.1007/s00134-015-4064-yTest https://hal.sorbonne-universite.fr/hal-01288664Test https://hal.sorbonne-universite.fr/hal-01288664/documentTest https://hal.sorbonne-universite.fr/hal-01288664/file/Gibelin_2016_Acute_respiratory.pdfTest |
| حقوق: | info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.94538B3B |
| قاعدة البيانات: | BASE |
| DOI: | 10.1007/s00134-015-4064-y |
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