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Mechanism of injury influences quality of life in survivors of acute respiratory distress syndrome

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Abstract

Objective

Growing evidence suggests that acute respiratory distress syndrome (ARDS) occurring as a consequence of primary (direct) lung injury differs from that resulting from secondary (indirect) lung injury in terms of radiographic appearance, response to interventions, and outcomes. We examined whether there are differences in quality of life (QOL) in survivors of ARDS attributable to the mechanism of underlying lung injury.

Design and setting

Prospective observational cohort study in 54 intensive care units in Canada and the United States.

Patients and participants

Survivors of ARDS (n = 73) were grouped according to underlying cause of ARDS (i.e., primary vs. secondary lung injury) and followed prospectively for 12 months.

Measurements and results

QOL was assessed using the Medical Outcomes Study 36-item Short Form Health Survey (SF-36) and the St. George's Respiratory Questionnaire (SGRQ), and spirometry was performed at each outpatient follow-up visit. At 3 months mortality and QOL outcomes were similar between the groups, but by 12 months patients with primary lung injury had significantly better QOL scores in four of eight SF-36 domains and in two of three domains of the SGRQ. Differences were not attributable to duration of ICU or hospital length of stay, duration of mechanical ventilation, comorbidities prior to the index illness, or differences in spirometry during the follow-up period.

Conclusions

QOL in survivors of ARDS appears to be influenced by the mechanism of lung injury (primary vs. secondary), lending support to the concept that ARDS is a heterogeneous condition.

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Acknowledgements

The authors thank Dr. Christine D'Arsigny for critical review of the manuscript.

Author information

Authors and Affiliations

  1. Kingston General Hospital, ONT K7L 2V7, Kingston, Canada

    Daren K. Heyland

  2. Department of Medicine, Queen’s University, Kingston, Ont., Canada

    Chris M. Parker & Daren K. Heyland

  3. Department of Community Health and Epidemiology, Queen’s University, Kingston, Ont., Canada

    Daren K. Heyland

  4. Faculty of Health Sciences, University of Ottawa, Ottawa, Ont., Canada

    Dianne Groll

  5. Altana Pharma, Constance, Germany

    Manfred Caeser

Authors
  1. Chris M. Parker
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  2. Daren K. Heyland
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  3. Dianne Groll
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  4. Manfred Caeser
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Corresponding author

Correspondence to Daren K. Heyland.

Additional information

This article is discussed in the editorial available at: http://dx.doi.org/10.1007/s00134-006-0345-9

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Parker, C.M., Heyland, D.K., Groll, D. et al. Mechanism of injury influences quality of life in survivors of acute respiratory distress syndrome. Intensive Care Med 32, 1895–1900 (2006). https://doi.org/10.1007/s00134-006-0344-x

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  • DOI: https://doi.org/10.1007/s00134-006-0344-x

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