Retrospective Analysis Of Clinical Data Of 87 Patients With Acute Respiratory Distress Syndrome

Objective: The clinical data of patients with ARDS were collected and analyzed retrospectively.Objective to explore the relationship between prognosis and severity of ICU ARDS,survival rate and mortality,parameters of disease severity and prognosis.Methods: Using the electronic medical record system of the First Affiliated Hospital of Guangxi Medical University,we searched the ICU patients who were diagnosed as ARDS during the 1 period from January 2013 to January2018.The clinical data of the statistical patients include:general conditions,such as gender,age,onset of incentives,and etiological examination results;the maximum difference between the following indexes at two time points in 24 hours and the outcome of ARDS was confirmed: APACHE-II score,leukocyte count(WBC),neutrophils absolute value(NEU),C reactive protein(CRP),serum lactate level(Lac),serum albumin level(ALB),lung Alveolar venous oxygen partial pressure difference(AaDPO2);disease outcome.Results:1.The clinical data of 87 patients were collected,including 61 males and 26 females,the average age(57.39?16.15)years,57 cases of death(65.5%)and 30cases(34.5%).According to the Berlin standard,17 cases,moderate 41 cases,and 29 cases were severe.2.Among the patients enrolled in the study,direct lung injury was the most common cause(53 cases,60.9%),and pneumonia was the main cause(46 cases,52.9%).3.The APACHE-II score,neutrophil absolute value,C reactive protein,blood lactic acid,serum albumin and AaDPO2 were related to the severity of ARDS(P < 0.05),but the absolute value of neutrophils and serum albumin decreased with the course of ARDS(P>0.05).4.The level of APACHE-II,neutrophil absolute,CRP,Lac and AaDPO2 had a positive correlation with the severity of ARDS(r=0.473,P<0.01;r=0.300,P=0.005;r=0.243,P=0.024;r=0.857,P<0.01;r=0.724,P<0.01),and the level of ALB was negatively correlated with the severity of ARDS(r=-0.656,P<0.01).5.APACHE-II score,Lac and AaDPO2 were independent risk factors for ARDS severity(P < 0.05),and ALB level was a protective factor for ARDS severity(P<0.05).6.Of the 87 patients,31 were positive for sputum culture,14 were positive for blood culture,3 were positive for venous catheter culture.In sputum,blood and venous catheterization,Acinetobacter Bauman was the highest positive pathogenic microorganism(77.4%,33.3%,66.7%).7.Of the 87 patients with ARDS,74 cases were combined with MODS,of which 27 cases were positive for gastric contents occult blood test,indicating hemorrhage of digestive tract,the incidence was 30.1%.The function failure of extrapulmonary viscera were 45 cases of renal failure,38 cases of circulatory failure,32 cases of liver failure,14 cases of nervous system dysfunction and 12 cases of coagulation dysfunction.Conclusion:1.Among the ARDS patients collected in this study,the mortality rates of mild,moderate and severe patients were 58.8%,68.3% and 65.5%,respectively,higher than those of foreign countries.2.The levels of APACHE-II,neutrophil absolute,CRP,Lac,ALB and AaDPO2 were related to the severity of ARDS,but the absolute value of neutrophils and the level of ALB were weakened with the course of ARDS disease.In the process of clinical diagnosis and treatment,dynamic monitoring of APACHE-II score,Lac,CRP and AaDPO2 levels is of great significance to the severity of ARDS,and has a guiding significance for the timing and measures of the treatment.Monitoring the levels of Lac and AaDPO2 is of great significance for the prognosis of ARDS.3.Patients with ICU ARDS often have MODS,and the most commonly seen organ is the kidney.4.In the etiological examination of ARDS patients,the most positive pathogenic microorganism was Acinetobacter Bauman.