title: Prediction of survival and mortality in patients with adult respiratory distress syndrome.
abstract: The adult or acute respiratory distress syndrome (ARDS) is an increased permeability pulmonary edema that occurs most often as a complication of bacterial sepsis, aspiration of gastric contents, or massive trauma. Clinically, the syndrome is recognized as acute respiratory failure with bilateral infiltrates on chest radiograph, a marked oxygenation defect, and normal or nearly normal cardiac function. Since its first comprehensive description > 25 yrs ago, the reported mortality rate of ARDS has remained high. Current series describe mortality rates in the range of 50% to 60%. The major cause of death in patients with ARDS seems to be bacterial sepsis and multiple organ dysfunction. Predictors of survival and mortality have been studied. Older patients (> or = 60 yrs) who develop bacterial sepsis and multiple organ dysfunction are at high risk to die. Younger patients who develop ARDS from trauma or other noninfectious causes have a better prognosis. Persistent metabolic acidosis on the first day of ARDS is a particularly poor prognostic sign.
authors.affiliation: Division of Pulmonology and Pulmonary Occupational Medicine, St. Louis University Health Sciences Center, MO.
authors.forename: T M
authors.initials: TM
authors.lastname: Hyers
mesh_terms: D000138:Acidosis / Q000209:etiology; D000328:Adult; D000367:Age Factors; D001424:Bacterial Infections / Q000150:complications / Q000401:mortality; D015984:Causality; D002423:Cause of Death; D006801:Humans; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality; D009104:Multiple Trauma / Q000150:complications; D011015:Pneumonia, Aspiration / Q000150:complications; D011237:Predictive Value of Tests; D011379:Prognosis; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D015996:Survival Rate