Abstract
The acute respiratory distress syndrome (ARDS) is an acute, severe alteration in lung structure and function characterized by hypoxemia, low-compliance lungs with a low funcional residual capacity, and diffuse radiographic infiltrates due to increased lung microvascular permeability [1]. Since first described in 1967 [2], the syndrome has been associated with a high mortality, and it is disappointing that despite many clinical and laboratory investigations the survival rates have remained virtually unchanged. Patients with the syndrome usually die either from the severity of lung impairment or from common complications. Whether the hypoxemia of acute respiratory failure is the usual cause of death in patients with ARDS is controversial. However, supportive measures such as mechanical ventilation with positive end-expiratory pressure (PEEP) [3] or extracorporeal membrane oxygenation [4,5], although technically successful at increasing arterial oxygenation, have had no obvious effect on reducing mortality. This suggests a need to focus on the prevention or treatment of other aspects of this syndrome, in addition to respiratory support measures.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Loyd JE, Newman JH, Brigham KL (1984) Permeability pulmonary edema: Diagnosis and management. Arch Intern Med 144: 143 – 147
Ashbaugh DG, Bigelow DB, Petty TL, Levine BE (1967) Acute respiratory distress in adults. Lancet 2: 319 – 323
Pepe PE, Hudson LD, Carrico CJ (1984) Early application of positive end-expiratory pressure in patients at risk for the adult respiratory distress syndrome. N Engl J Med 311: 281 – 286
Zapol WM, Snider MT, Hill JD, et al (1979) Extracorporeal membrane oxygenation in severe acute respiratory failure: A randomized prospective study. JAMA 242: 2193 – 2196
Morris AH, Wallace CJ, Menlove RL, Clemmer TP, Orme JF, Weaver LK, Dean NC, Thomas F, East TD, Pace NL, Suchyta MR, Beck E, Bombino M, Sitting DF, Böhm S, Hoffmann B, Becks H, Butler S, Pearl J, Rasmusson B. Randomized Clinical Trial of Pressure-controlled Inverse Ratio Ventilation and Extracorporeal C02 Renoval for Adult Respiratory Distress Syndrome. Am J Respir Crit Care Med 1994, 149: 295 – 305
Pepe PE, Potkin RT, Reus DH, Hudson LD, Carrico CJ (1982) Clinical predictors of the adult respiratory distress syndrome. Am J Surg 144: 124 – 130
Montgomery B, Stager MA, Carrico CJ, Hudson LD (1985) Causes of mortality in patients with the adult respiratory distress syndrome Am Rev Respir Dis 132: 485 – 489
Bell RC, Coalson JJ, Smith JD, Johanson WG (1983) Multiple organ system failure and infection in adult respiratory distress syndrome. Ann Intern Med 99: 293 – 298
Fowler AA, Hamman RF, Good JT, et al (1983) Adult respiratory distress syndrome: Risk with common predisposition. Ann Intern Med 98: 593 – 597
Milberg JA, Davis DR, Steinberg KP, Hudson LD (1995) Improved survival of patients with ARDS. 1983-1993. JAMA, 273: 306 - 309
Rinaldo JE (1986) The prognosis of the adult respiratory distress syndrome. Inappropriate pessimism? Chest 90: 470 – 471
Bernard GR, Artigas A, Brigham KL et al (1994). The American-European consensus conference on ARDS. Am J Respir Crit Care Med 149: 818 – 824
Shuster DP (1995). What is acute lung injury? What is ARDS? Chest 107: 1721 – 1726
Kollef MH, Shuster DP (1995). The acute respiratory distress syndrome. N Engl J Med 332: 27 – 37
Artigas A, Carlet J, Chastang C, Le Gall JR, Blanch L, Fernández R. Adult respiratory distress syndrome: clinical presentation, prognostic factors and outcome. In: Artigas A, Lemaire F, Suter PM, Zapol WM (eds) Adult respiratory distress syndrome. Churchill Livingstone, Edinburgh 1992, pp 509 – 525
Artigas A, Carlet J, Le Gall JR, Chastant C, Blanch L, Fernández R. Clinical presentation, prognostic factors and outcome of ARDS in the European Collaborative Study (1985-1987). In: Zapol W, Lemaire F (eds) Adult respiratory distress syndrome. Marcel Dekker. New York 1991, pp 37 – 63
Krafft P, Fridrich T, Pernerstorfer RD, Fitzgerald D et al (1996) The acute respiratory distress syndrome: definitions, severity and clinical outcome. An analysis of 101 clinical investigations. Intensive Care Med 22: 519 – 529
Anzueto A, Baughman R, Guntapalli K et al (1996) Aerosolized surfactant in adults with sepsis-induced acute respiratory distress syndrome. N Engl J Med 334: 1417 – 1421
Brochard L, Roudot-Thoraval F, and the collaborative group on Vt reduction (1997) Tidal volume (Vt) reduction in acute respiratory distress syndrome (ARDS): a multicenter randomized study. Am J Respir Crit Care 155: A505
Stewart E, Meade M, Granton et al (1997) Pressure and volume limited ventilation strategy (PLUS) in patients at high risk for ARDS: Results of a multicenter trial. Am J Respir Crit Care 155: A505.
Hudson LD, Milberg JA, Anardi D, Maunder RJ (1995) Clinical risks for development of the acute respiratory distress syndrome. Am J Respir Crit Care 151: 293 – 301
Fowler AA, Hamman RF, Zerbe GO, Benson KN, Hyers TM (1985) Adult respiratory distress syndrome: Prognosis after onset. Am Rev Respir Dis 132: 472 – 478
Artigas A, Mancebo J (1987) Etiology and multiple organ system failure as prognostic factors in ARDS. In: Vincent JL (ed) Update in Intensive Care and Emergency Medicine. Springer-Verlag, Berlin, pp 163 – 169
Mancebo J, Artigas A (1987) A clinical study of the adult respiratory distress syndrome Crit Care Med 15: 243 - 246
Bone RC, Balk R, Slotman G, Maunder R, Silverman H, Hyers TM, Kerstein MD (1992) Adult Respiratory Distress Syndrome: Sequence and importance of development of multiple organ failure. Chest 101: 320 – 326
Bone RC, Maunder R, Slotman G, Silverman H, Hyers TM, Kerstein MD, Ursprung JJ (1989) An early test of survival in patients with the adult respiratory distress syndrome. The Pa02/FI02 ratio and its differential response to conventional therapy. Chest 96: 849 – 851
Artigas A, Lemeshow S, Rue M, Avrunin J, Mestre J, Le Gall JR and ICU Scoring Group (1994) Risk stratification and outcome assessment of patients with acute lung injury. Am J Respir Crit Care Med 149: Al029
De Latorre FJ, Estopa R, Artigas A (1983) Intercambio gaseoso como factor pronóstico en el sÃndrome de distress respiratorio del adulto. Med Intensiva 7: 1 – 6
Lamy M, Fallai RJ, Koeniger E, et al (1976) Pathologie features and mechanisms of hypoxemia in adult respiratory distress syndrome. Am Rev Respir Dis 114: 267 – 284
National Heart, Lung and Blood Institute, Division of Lung Diseases (1979) Extracorporeal Support for Respiratory Insufficiency: A Collaborative Study. Bethesda, MD, NIH
Barlett RH, Morris AH, Fairley BF, Hirsh R, O’Connor N, Pontoppidan H (1986) A prospective study of acute hypoxic respiratory failure. Chest 89: 684 – 689
Fein AM, Lippmann M, Holtzman H, Eliraz A, Goldberg SK (1983) The risk factors, incidence, and prognosis of ARDS following septicemia. Chest 83: 40 – 42
Kaplan RL, Sahn SA, Petty TL (1979) Incidence and outcome of the respiratory distress syndrome in Gram-negative sepsis. Arch Intern Med 139: 867 – 869
Idell S, Cohen AB (1983) Bronchoalveolar lavage in patients with the adult respiratory distress syndrome. Clin Chest Med 6: 459 – 71
Bachofen M, Weibel ER (1982) Structural alterations of lung parenchyma in the adult respiratory distress syndrome. Clin Chest Med 3: 35 – 56
Holter JF, Weiland JE, Patch ER, Gadek JE, Davis WB (1986) Protein permeability in the adult respiratory distress syndrome. Loss of size selectivity of alveolar epithelium. J Clin Invest 78: 1513 – 22.
Sprung CL, Long WM, Marciai EH et al (1987) Distribution of proteins in pulmonary edema. The value of fractional concentrations. Am Rev Respir Dis 136: 957 – 63
Fowler AA, Hyers TM, Fisher BJ, Bechard DE, Centor RM, Webster RO (1987) The adult respiratory distress syndrome cell populations and soluble mediators in the air spaces of patients at high risk. Am Rev Respir Dis 136: 1225 – 31
Weiland JE, Davis WB, Holter JF, Mohammed JR, Dorinsky PM, Gadek JE (1986) Lung neutrophils in the adult respiratory distress syndrome: clinical and pathophysiologic significance. Am Rev Respir Dis 133: 218 – 25
Martin TR, Pistorese BP, Hudson LD, Maunder RJ (1991) The function of lung and blood neutrophils in patients with the adult respiratory distress syndrome: implications for the pathogenesis of lung infections. Am Rev Respir Dis 144: 254 – 62
Repine JE, Beehler CJ (1991) Neutrophils and adult respiratory distress syndrome: two interlocking perspectives in 1991. Am Rev Respir Dis 144: 251 – 2
Suter PM, Suter S, Girardin E, Roux Lombard P, Grau GE, Dayer JM. High broncho alveolar levels of tumor necrosis factor and its inhibitors, interleukin-1, interferon, and elastase, in patients with respiratory distress syndrome after trauma, shock, or sepsis. Am Rev Respir Dis 145:1016–22
Lee CT, Fein AM, Lippman M, Holtzman H, Kimbel P, Weinbaum G (1981) Elastalytic activity in pulmonary lavage fluid from patients with the adult respiratory distress syndrome. N Engl J Med 304: 192 – 196
Shasby DM, Fox RB, Harada RN, Repine JE (1982) Reduction of the edema of acute hyperoxic lung injury by granulocyte deplation. J Appi Physiol 52: 1237 – 1244.
Steinberg KP, Milberg JA, Martin TR, Maunder RJ, Cockrill BA, Hudson LD (1994) Evolution of bronchoalveolar cell populations in the respiratory distress syndrome. Am J Respir Crit Care Med 150: 113 – 122
Goodman RB, Strieter RM, Martin DP, et al (1996) Inflammatory cytokines in patients with persistence of the acute respiratory distress syndrome. Am J Respir Crit Care Med 154: 602 – 611
Artigas A, Fontcuberta J, Castella J, Rutllant M (1985) Coagulation disorders in the adult respiratory distress syndrome. In: Vincent JL (ed) Update in Intensive Care and Emergency Medicine. Springer-Verlag, Berlin, pp 84 – 89
Fontcuberta J, Artigas A, Sala N, et al (1986) Inhibitors of blood coagulation in adult respiratory distress syndrome. Intensive Care Med 12: 224 (Abst)
Zapol WM, Frikker MJ, Pontoppidan H, Wilson RS, Lynch KE (1991) The adult respiratory distress syndrome at Massachusetts General Hospital: Etiology, progression and survival rates 1978–1988. In: Adult respiratory distress syndrome. De. WM Zapol, F Lemaire. Marcel Dekker, New York, pp 367 – 380
Bartlett RH, Gazzaniga AB, Wilson AF, Medley T, Wetmore N (1975) Mortality prediction in adult respiratory insufficiency. Chest 6: 680 – 684
Shimada Y, Yoshiya I, Tanaka K, Sone S, Sakurai M (1979) Evaluation of the progress and prognosis of adult respiratory distress syndrome. Chest 76: 180 – 186
Jardin F, Prost JF, Bazin M, Desfond P, Ozier Y, Margairez A (1982) Modalités évolutives du syndrome de détresse respiratoire aigüe de l’adulte: Valeur pronostique d’un indice de gravité tiré de I’oxygenation arterielle. Nouv Press Med 11: 29 – 33
Smith PEM, Gordon IJ (1986) An index to predict outcome in adult respiratory distress syndrome. Intensive Care Med 12: 86 – 89
Hickling KG, Henderson SJ, Jackson R (1990) Low mortality associated with low volume pressure limited ventilation with permissive hypercapnia in severe adult respiratory distress syndrome. Intensive Care Med 16: 372 – 377
Hickling KG, Walsh J, Henderson S, Jackson R (1994) Low mortality rate in adult respiratory distress syndrome using low–volume, pressure-limited ventilation with permissive hypercapnia: a prospective study. Crit Care Med 22: 1568 – 1578
Morel D, Dargent F, Bachmann M, Suter PM, Junot AF (1985) Pulmonary extraction of serotonin and propanolol in patients with ARDS. Am Rev Respir Dis 132: 479 – 484
Murray JF, Matthay MA, Luce JM, Flick MR (1988) An expanded definition of the adult respiratory distress syndrome Am Rev Respir Dis 138: 720 – 723
Schuster DP (1992) Prediction outcome after ICU admission: The art and science of assessing risk. Chest 102: 1861
Lemeshow S, Le Gall JR (1994) Modeling the severity of illness of ICU patients: a system update. JAMA 272: 1049 – 1055
Lemeshow S, Teres D, Klar J et al (1993) Mortality probability models (MPM II) based on an international cohort of intensive care unit patients. JAMA 270: 2478 – 2486
Le Gall JR, Lemeshow S, Saulnier F et al (1993) A new simplified acute physiology score (SAPS II) based on an European/North American multicenter study. JAMA 270: 2957 – 2963
Knauss WA, Wagner DP, Drapper ET et al (1991) The APACHE III prognostic system: Risk prediction of hospital mortality for critically ill hospitalized adults. Chest 100: 1619 – 1636
Lemeshow S, Klar J, Teres D et al (1994) Mortality probability models for patients in the intensive care unit for 48 or 72 hours: A prospective, multicenter study. Crit Care Med 22: 1351 – 1358
Le Gall JR, Loirat P, Alperovitch A et al (1984) A simplified acute physiology score for ICU patients. Crit Care Med 12: 975 – 977
Knaus WA, Zimmerman JE, Wagner DP et al (1981) APACHE - Acute physiology and chronic health evaluation: A physiologically based classification system. Crit Care Med 9: 591 – 597
Knaus WA, Draper EA, Wagner DP et al (1985) APACHE II: A severity of disease classification system. Crit Care Med 13: 818 – 829
Knaus WA, Sun X, Hakim RB, Wagner DP (1994) Evaluation of definitions for adult respiratory distress syndrome. Am J Respir Crit Care 150: 311 – 317
Le Gall JR, Brun-Buisson C, Trunet P, et al (1982) Influence of age, previous health status and severity of illness on outcome from intensive care. Crit Care Med 10: 575 – 577
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1998 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Artigas, A. (1998). Pronostic Factors and Outcome of ALI. In: Marini, J.J., Evans, T.W. (eds) Acute Lung Injury. Update in Intensive Care and Emergency Medicine, vol 30. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60733-2_2
Download citation
DOI: https://doi.org/10.1007/978-3-642-60733-2_2
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-64532-7
Online ISBN: 978-3-642-60733-2
eBook Packages: Springer Book Archive