Acute Respiratory Distress Syndrome in Burn Patients: A Comparison of the Berlin and American-European Definitions
| Autor: | Allison R. Buel, Leopoldo C. Cancio, Jonathan L. Henderson, J Alan Waters, Ian J. Stewart, Christy R. Sine, Nehemiah T. Liu, Kevin K. Chung, Jonathan B. Lundy, James K. Aden, Slava Belenkiy, Jeremy W. Cannon, Andriy I. Batchinsky |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty ARDS medicine.medical_treatment Population Acute Lung Injury Poison control Lung injury 03 medical and health sciences 0302 clinical medicine Injury Severity Score Interquartile range Internal medicine medicine Prevalence Humans 030212 general & internal medicine education Mechanical ventilation education.field_of_study Respiratory Distress Syndrome business.industry Mortality rate Rehabilitation 030208 emergency & critical care medicine Middle Aged medicine.disease Respiration Artificial Surgery Emergency Medicine Female business Burns |
| Zdroj: | Journal of burn careresearch : official publication of the American Burn Association. 37(5) |
| ISSN: | 1559-0488 |
| Popis: | The purpose of this study was to compare the Berlin definition to the American-European Consensus Conference (AECC) definition in determining the prevalence of acute respiratory distress syndrome (ARDS) and associated mortality in the critically ill burn population. Consecutive patients admitted to our institution with burn injury that required mechanical ventilation for more than 24 hours were included for analysis. Included patients (N = 891) were classified by both definitions. The median age, % TBSA burn, and injury severity score (interquartile ranges) were 35 (24-51), 25 (11-45), and 18 (9-26), respectively. Inhalation injury was present in 35.5%. The prevalence of ARDS was 34% using the Berlin definition and 30.5% using the AECC definition (combined acute lung injury and ARDS), with associated mortality rates of 40.9 and 42.9%, respectively. Under the Berlin definition, mortality rose with increased ARDS severity (14.6% no ARDS; 16.7% mild; 44% moderate; and 59.7% severe, P < 0.001). By contrast, under the AECC definition increased mortality was seen only for ARDS category (14.7% no ARDS; 15.1% acute lung injury; and 46.0% ARDS, P < 0.001). The mortality of the 22 subjects meeting the AECC, but not the Berlin definition was not different from patients without ARDS (P = .91). The Berlin definition better stratifies ARDS in terms of severity and correctly excludes those with minimal disease previously captured by the AECC. |
| Databáze: | OpenAIRE |
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