Chest
Clinical Investigations in Critical CareImproved Survival in ARDS Patients Associated with a Reduction in Pulmonary Capillary Wedge Pressure
Section snippets
MATERIALS AND METHODS
We performed a retrospective analysis of our experience caring for patients with ARDS who were admitted to our intensive care unit over a three-year period from January 1984 to January 1987. The list of patients was generated from our ICU data base which tracks all admissions and major diagnoses including all patients with a diagnostic listing of ARDS. Patient charts were reviewed by the principal investigators to determine eligibility for inclusion in the study.
Patients with the following ARDS
RESULTS
Forty patients met previously mentioned ARDS criteria and included equal numbers of men and women (Table 1). The mean age of our patients was 46 with a range from 16 to 81. The mean Ppw for all patients at entry into the study was 12 mm Hg and subsequently was reduced to 10 mm Hg at 24 and 48 hours of therapy. The mean probability of death as predicted by APACHE II score on the day of meeting ARDS criteria was 17 percent.
The mean length of stay in the ICU was 12 days, while the mean length of
DISCUSSION
The acute lung injury in ARDS leads to alveolar flooding with proteinaceous fluid producing lung mechanical and gas exchange abnormalities.1 Pathologically, this early or exudative phase spanning the first one to five days following lung injury is characterized by alveolar flooding, inflammatory cell infiltrate, and hyaline membrane formation, with minimal destruction of lung architecture.11 This can well be thought of as a reversible lung lesion, since patients recovering at this point in
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Cited by (0)
This study was supported by NIH grant HL 30835.
Manuscript received March 7; revision accepted October 5.