Prognostic Correlative Factors Of Acute Respiratory Distress Syndrome

Objective:The study is aiming to explore the etiologies, physiologic, clinical feature, marginality and its predictor of Acute Respiratory Distress Syndrome (ARDS).Methods:A retrospective analysis of 82 RICU patients who were cured by affiliated hospital of Yanbian University from January 2003 to December 2010. The acute physiology, chronic health evaluation II and multiple organ dysfunction score were recorded when all the patients were confirmed diagnosis, and other variable records were age, sex, history of chronic patient, duration of diagnosis, the duration of RICU ventilation, parameter of ventilation, blood gas analysis, blood routine, blood biochemistry, sputum culture and chest X-ray.Results:1.82 cases were identified with ARDS during 8 years, the death rate is 41.2%. The main reason of death is MODS which was occupied 42.3% of all the dead patients.2. The major risk factors about ARDS were pneumonia and multiple traumas.3. The average age and Maximum positive end-expiratcry pressure were lower in the group of ARDSexp than in the group of ARDSp(P<0.05). The PaO2/FiO2 (Od) was about the same before the treatment. But, the difference about Id was very obviously in these two groups. The group ARDSexp is better than the other group (P <0.01).4. There are significant differences between survivors and no survivors with respect to duration of diagnosis, history of chronic patient, duration of RICU, chronic health evaluation II and multiple organ dysfunction score (P<0.05). The A-aDO2 and RI were higher in the group of survivors than the group of no survivors. And the difference was evident(P<0.05).5. The mortality of ARDS has the positive correlation with the duration of diagnosis and the number of extra pulmonary organ dysfunction, the correlation coefficients were 0.249(P<0.05) and 0.433(P<0.01).6. The results of logistic regression analysis told us that the number of extra pulmonary organ dysfunction, the duration of diagnosis, chronic health evaluation II, A-aDO2 and RI were the independent risk factors that affected the treatment of ARDS.Conclusions:1. Pneumonia is the primary cause in the acute respiratory distress syndrome of extra-pulmonary origin patients, and the main reason of the acute respiratory distress syndrome of extra-pulmonary origin patients is multiple traumas.2. MODS are the main reason leading to death.3. The number of extra pulmonary organ dysfunction, duration of diagnosis, chronic health evaluation II, A-aDO2 and RI could be used as the important prognostic indicators for ARDS.