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  1. Kathryn Prior
  1. Correspondence to Dr Kathryn Prior, Heart and Lung Unit, Torbay Hospital, Lawes Bridge, Torquay, Devon TQ2 7AA, UK; kathrynbrain{at}doctors.net.uk

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Epidemiology of ARDS

LUNG SAFE study was an international, multi-centre, prospective cohort study of patients undergoing invasive or non-invasive ventilation who were admitted to 459 intensive care units (ICU) for 4 consecutive weeks in the northern hemisphere winter of 2014 in 50 countries (doi: 10.1001/jama.2016.0291). The primary outcome was the proportion of admissions diagnosed with acute respiratory distress syndrome (ARDS). The secondary outcomes were assessment of clinician recognition of ARDS, what ventilatory management was used, and clinical outcomes. Of 29 144 patients admitted, 3022 (10.4%) had ARDS, 2377 were managed with mechanical ventilation which was 23.4% of those ventilated on ICU during this period. The prevalence of mild ARDS was 30.0%, moderate 46.6% and severe 23.4%. When the clinician recognised ARDS this was associated with higher positive end expiratory pressure ventilation, greater use of neuromuscular blockade, and prone positioning. Hospital mortality was 34.9% for those with mild, 40.3% for those with moderate, and 46.1% for those with severe ARDS.

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