Analyzing The Clinical Data Of 48 Adult Severe Ards:A Retrospectively Study

ObjectiveTo discuss the clinical characters of the adult patients diagnosed severe acute respiratory distress syndrome (ARDS) and the differences between the death group and survival group.MethodsCollecting the clinical datas of 48 adult severe ARDS cases which was conformed to the Berlin definition in the Intensive Care Unit of the second affiliated hospital of Chong Qing Medical University. Analysis the clinical data(including sex, age, etiology, basic diseases, blood gas analysis, PCT, lactic acid, CRP, the mechanical ventilation way and time, ICU stay time, hospital days, APACHEII score, whether to develop into MODS and the number of cumulative extrapulmonary organ and so on).All the variables were analyzed by SPSS20.0.Results1. There were 48 cases included, male 33 cases, and female 15 cases.14 cases in survival group and 34 cases in death group. The mortality of all cases was 70.83%.2. There were 33 cases with age more than 65 years old, and its mortality was 87.88%, higher than that age below 65.31 cases had one or more basic diseases before 6 months onset, and the mortality was also higher than that had no basic disease. The ventilation time in patients after surgery was longer than pulmonary infection or sepsis.3. The mainly cause of severe ARDS was endogenous lung injuries for 28 cases (58.33%). Pulmonary infection was the first reason, then was interstitial pneumonia. Exogenous lung injuries had 20 cases, and the mean reasons were sepsis and surgery.4.There were no statistically significant differences in sex, cause, oxygenation index, lactic acid, creatinine, CRP, ICU stay time, hospital days, ventilation way and time (P>0.05) between death group and survival group. PCT and APACHE Ⅱ score were higher in death group than survival group ((5.24±3.31) VS (1.38±1.39), P=0.033; (20.15±6.89) VS (10.40±3.44), P=0.042).5.There were 33 cases (68.75%) occured MODS in ARDS.16 cases (48.48%) with one cumulative extrapulmonary organ failure,6 cases (30.30%) in 2 organs,2 cases(9.09%) in 3 organs and 3 cases (12.12%) in 4 organs. And the mortality was higher with the number of the cumulative organs.Conclusion1. The mortality was high in elder severe ARDS. Age was the influencing factor of mortality.2. There were statistically differences in basic disease, PCT, APAHCE II score between the death group and survival group.3. The ventilation time in patients after surgery was long, and its difficult to remove the ventilator.4. The incidence of MODS in severe ARDS reminded high, and the motality was also high in ARDS with MODS. Actively protecting the function of important organs can reduce the mortality of ARDS other than treating basic disease and mechanical ventilation.