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Long term functional limitations in survivors of ARDS
  1. S Cooper
  1. Whittington Hospital, London, samanthacooper{at}

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One hundred and nine survivors of ARDS (mean age 45 years) were assessed at 3, 6 and 12 months after discharge from ICUs in Toronto. Patients had a mild restrictive pattern on lung function testing with mild to moderate reduction in carbon monoxide transfer factor at 3 months and, although this improved slightly (by 9%), it only reached 72% of predicted values.

Of the other end points assessed, the distance walked in 6 minutes improved over the 12 months but still remained lower than predicted (66%). The persistent functional limitation was largely a result of muscle wasting and weakness and, to a lesser extent, to entrapment neuropathy, heterotopic ossification, and intrinsic pulmonary morbidity. These sequelae were not compared with a control group of ICU survivors who did not have ARDS, so the consequences may not be specific to the syndrome but upshots of any severe critical illness. The absence of systemic corticosteroid treatment, the absence of illness acquired during the ICU stay, and rapid resolution of the lung injury and multiorgan failure were associated with a better outcome at 1 year.

Survivors of ARDS thus have persistent functional disability and reduced carbon monoxide transfer factor at 1 year after discharge from ICUs. However, these features may not be specific to ARDS.

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