Abstract
Rationale: ARDS is a life threatening condition, and associated with a poor prognosis. Drugs are important risk factor of ARDS as well as other major risk factors such as pneumonia, sepsis, aspiration. To our knowledge, there have been few reports concerning about clinical features and prognosis of drug-associated ARDS compared with those of non-drug associated ARDS.
Methods: 181 patients with ARDS who met the Berlin Criteria were enrolled from 1 October 2004 to 31 December 2014 at our institution. We divided the patients into two groups: drug-associated ARDS (DARDS) group (n= 21) and non-drug-associated ARDS (non-DARDS) group (n = 160), followed by the definition of Dhokarh et al (Chest 2012; 142: 845-850). We evaluated each group for 28 days prognosis, ventilation free days, and other clinical features.
Results: The APACHE II scores (18 vs 23, p= .001) and SOFA scores (5 vs 7, p= .003) were significantly lower, and P/F ratio (138.0 vs 101.4, p= .008) was higher in the DARDS group compared with those of the non-DARDS group. In the DARDS group, HRCT scores (median, 293.1 vs 208.3, p= .000) suggestive of the extent of fibroproliferation (Radiology 2006; 238: 321-329) and serum LDH (440 vs 312, p= .001) were significantly higher than those of the non-DARDS group. Furthermore, the ventilator-free days were higher (17 days vs 0 day, p= .011), and the 28 days mortality tended to be better (28.6% vs 38.1%, p= .476) in the DARDS group compared with those of non-DARDS group.
Conclusion: In patients with drug associated ARDS, although lung damage with fibroproliferation was more severe, ventilator weaning was significantly earlier and prognosis was not worse than those of non-drug associated ARDS.
- Copyright ©ERS 2015