Influence of pulmonary and extra-pulmonary factors on prognosis of acute respiratory distress syndrome

Objective The influence of pulmonary and extra-pulmonary factors on the prognosis of acute respiratory distress syndrome (ARDS) were analyzed.Methods Clinical data of patients with ARDS in ICU of our hospital from March 2000 to December 2001 were collected, and they were divided into pulmonary (ARDS P) and extra-pulmonary (ARDS EXP-) groups according to the inducing factors. The significances on the prognosis were evaluated by t-test and χ 2.Results There were 15 cases with ARDS P and 29 with ARDS EXP- including male/female 4/11 and 14/15, age ( 59.0- ±18.5-) and ( 52.7- ±21.9-) years old, respectively. There were no significant differences between the two groups on the following items as age, underlying diseases, nutritional condition, PaO 2/FiO 2, Q S/Q T, APACHE-Ⅱ score, PEEP level, time of ventilation support, septic shock and multiple organic dysfunction syndrome (MODS, P 0.05-).The oxygenation of ARDS EXP- was improved more significantly than ARDS P by ventilation support (P 0.05-). Also, there were no significant differences on the incidence of indefinite pathogen and mixed infection between the two groups (P 0.05-) but the antibiotic effect in ARDS P was lower than that in ARDS EXP- (P 0.05-). The mortality rate was higher in ARDS P group than that in ARDS EXP- ( 93.3%- vs 44.8%-, P 0.01-).Conclusion The mortality rate in ARDS P is significant higher than that in ARDS EXP- due to the uncontrollable pulmonary infection.