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Prognostic factors in acute respiratory distress syndrome: a retrospective multivariate analysis including prone positioning in management strategy

Intensive Care Medicine volume 29, pages 1435–1441 (2003)Cite this article

Abstract

Objective

To investigate the prognostic factors in acute respiratory distress syndrome (ARDS) patients focusing on the use of prone positioning (PP).

Design and setting

Retrospective study conducted in an intensive care unit of a university hospital.

Patients

All consecutive mechanically ventilated ARDS patients surviving on day 7 after the diagnosis of ARDS.

Methods

The study included all ARDS patients who survived more than 7 days after ARDS diagnosis between January 1995 and December 2002. Demographic and respiratory variables were collected on day 1, and the management of ARDS was analyzed during the first 7 days (n=125). We performed a univariate analysis and a stepwise logistic regression analysis comparing survivors and nonsurvivors on day 28 and at 2 and 6 months.

Results

Mortality rates on day 28 and at 2 and 6 months were 21.6%, 32%, and 44% respectively. A SAPS II score less than 49, McCabe score, and the use of PP introduced in the first 7 days of ARDS management appeared to be independently correlated with a decrease in mortality.

Conclusions

The SAPS II score, the McCabe score, and use of PP are independently correlated with the outcome in ARDS patients.

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Affiliations

  1. Polyvalent Intensive Care Unit, Bellevue University Hospital, 42055, Saint Etienne Cedex 2, France

    Christophe Venet, Stephane Guyomarc'h, Juliette Pingat, Christophe Michard, Monique Bertrand, Pierre Gery, Dominique Page, Regine Vermesch, Jean Claude Bertrand, Jean Claude Bertrand & Fabrice Zeni

  2. Clinical Pharmacology Unit, Bellevue University Hospital, 42055, Saint Etienne Cedex 2, France

    Silvy Laporte

Authors
  1. Christophe Venet
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  2. Stephane Guyomarc'h
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  3. Juliette Pingat
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  4. Christophe Michard
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  5. Silvy Laporte
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  6. Monique Bertrand
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  7. Pierre Gery
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  8. Dominique Page
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  9. Regine Vermesch
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  10. Jean Claude Bertrand
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  11. Fabrice Zeni
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Correspondence to Christophe Venet.

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Venet, C., Guyomarc'h, S., Pingat, J. et al. Prognostic factors in acute respiratory distress syndrome: a retrospective multivariate analysis including prone positioning in management strategy. Intensive Care Med 29, 1435–1441 (2003). https://doi.org/10.1007/s00134-003-1856-2

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  • DOI: https://doi.org/10.1007/s00134-003-1856-2

Keywords

  • ARDS
  • Mortality
  • Prone positioning
  • Multivariate analysis
  • Prognosis
  • Clinical study