Intensive Care Medicine

, Volume 25, Issue 11, pp 1231–1236

ARDS in patients with thermal injury

Authors

  • D. R. Dancey
    • Division of Respiratory Medicine and the Critical Care Medicine Program, Mt. Sinai Hospital, University Avenue, University of Toronto, Toronto, Ontario, Canada, M5G IX5 Tel: + (416)586–8774 Fax: + (4 16)-5 86-59 81 e-mail: tom.stewart@utoronto.ca
  • J. Hayes
    • Division of Respiratory Medicine and the Critical Care Medicine Program, Mt. Sinai Hospital, University Avenue, University of Toronto, Toronto, Ontario, Canada, M5G IX5 Tel: + (416)586–8774 Fax: + (4 16)-5 86-59 81 e-mail: tom.stewart@utoronto.ca
  • M. Gomez
    • Division of Plastic Surgery, Department of Surgery, Ross Tilley Burn Centre, Sunnybrook and Women's College Health Science Center, University of Toronto, Toronto, Ontario, Canada
  • D. Schouten
    • Division of Respiratory Medicine and the Critical Care Medicine Program, Mt. Sinai Hospital, University Avenue, University of Toronto, Toronto, Ontario, Canada, M5G IX5 Tel: + (416)586–8774 Fax: + (4 16)-5 86-59 81 e-mail: tom.stewart@utoronto.ca
  • J. Fish
    • Division of Plastic Surgery, Department of Surgery, Ross Tilley Burn Centre, Sunnybrook and Women's College Health Science Center, University of Toronto, Toronto, Ontario, Canada
  • W. Peters
    • Division of Plastic Surgery, Department of Surgery, Ross Tilley Burn Centre, Sunnybrook and Women's College Health Science Center, University of Toronto, Toronto, Ontario, Canada
  • A. S. Slutsky
    • Division of Respiratory Medicine and the Critical Care Medicine Program, Mt. Sinai Hospital, University Avenue, University of Toronto, Toronto, Ontario, Canada, M5G IX5 Tel: + (416)586–8774 Fax: + (4 16)-5 86-59 81 e-mail: tom.stewart@utoronto.ca
  • T. E. Stewart
    • Division of Respiratory Medicine and the Critical Care Medicine Program, Mt. Sinai Hospital, University Avenue, University of Toronto, Toronto, Ontario, Canada, M5G IX5 Tel: + (416)586–8774 Fax: + (4 16)-5 86-59 81 e-mail: tom.stewart@utoronto.ca
ORIGINAL

DOI: 10.1007/PL00003763

Cite this article as:
Dancey, D., Hayes, J., Gomez, M. et al. Intensive Care Med (1999) 25: 1231. doi:10.1007/PL00003763

Abstract

Objective: To determine the time to onset of the adult respiratory distress syndrome (ARDS) in patients with thermal injury requiring mechanical ventilation. Secondarily, to consider the burn-related risk factors, demographics, incidence, and mortality for ARDS in this population.¶Design: Retrospective chart review; ARDS defined according to the American-European Consensus Conference and the Lung Injury Severity Score definitions.¶Setting: Regional, tertiary referral, adult burn unit in a university teaching hospital.¶Patients and participants: Patients with thermal injury requiring mechanical ventilation, admitted between 1 January 1991 and 28 February 1995.¶Interventions: None.¶Measurements and results: Of 469 consecutive admissions, 126 (26.9 %) received intubation and mechanical ventilation. ARDS was defined according to the American-European Consensus and Lung Injury Severity Score (score > 2.5) definitions. The mean time to onset of ARDS from admission to the burn unit was 6.9 ± 5.2 and 8.2 ± 10.7 days when defined by the American-European Consensus and Lung Injury Severity Score definitions respectively (p = 0.41). Of the intubated patients, 53.6 and 45.2 % developed ARDS according to the American-European Consensus and Lung Injury Severity Score definitions, respectively (p = 0.19). Using multivariate logistic analysis, only age proved to be an independent risk factor for the development of ARDS (p = 0.03), although there was a trend toward an increased incidence of inhalation injury in patients with ARDS. Mortality was not significantly greater (41.8 vs 32.2 %) in those with ARDS compared to those without (p = 0.27).¶Conclusions: According to the American-European Consensus Conference and the Lung Injury Severity Score definitions, ARDS is common in the adult burn population and has a delayed onset compared to most critical care populations. We found age to be a major predisposing factor for ARDS.

Key words Adult respiratory distress syndromeMechanical ventilationThermal injuryBurnInhalation injuryIncidenceTime to onset

Copyright information

© Springer-Verlag Berlin Heidelberg 1999