title: ARDS in patients with thermal injury.
abstract: OBJECTIVE
  To determine the time to onset of the adult respiratory distress syndrome (ARDS) in patients with thermal injury requiring mechanical ventilation. Secondarily, to consider the burn-related risk factors, demographics, incidence, and mortality for ARDS in this population.
  
  
  METHODS
  Retrospective chart review; ARDS defined according to the American-European Consensus Conference and the Lung Injury Severity Score definitions.
  
  
  METHODS
  Regional, tertiary referral, adult burn unit in a university teaching hospital.
  
  
  METHODS
  Patients with thermal injury requiring mechanical ventilation, admitted between 1 January 1991 and 28 February 1995.
  
  
  METHODS
  None.
  
  
  RESULTS
  Of 469 consecutive admissions, 126 (26.9%) received intubation and mechanical ventilation. ARDS was defined according to the American-European Consensus and Lung Injury Severity Score (score > 2.5) definitions. The mean time to onset of ARDS from admission to the burn unit was 6.9 +/- 5.2 and 8.2 +/- 10.7 days when defined by the American-European Consensus and Lung Injury Severity Score definitions respectively (p = 0.41). Of the intubated patients, 53.6 and 45.2% developed ARDS according to the American-European Consensus and Lung Injury Severity Score definitions, respectively (p = 0.19). Using multivariate logistic analysis, only age proved to be an independent risk factor for the development of ARDS (p = 0.03), although there was a trend toward an increased incidence of inhalation injury in patients with ARDS. Mortality was not significantly greater (41.8 vs 32.2%) in those with ARDS compared to those without (p = 0.27).
  
  
  CONCLUSIONS
  According to the American-European Consensus Conference and the Lung Injury Severity Score definitions, ARDS is common in the adult burn population and has a delayed onset compared to most critical care populations. We found age to be a major predisposing factor for ARDS.
authors.affiliation: Division of Respiratory Medicine, Mt. Sinai Hospital, University of Toronto, Ontario, Canada.
authors.forename: D R
authors.initials: DR
authors.lastname: Dancey
authors.forename: J
authors.initials: J
authors.lastname: Hayes
authors.forename: M
authors.initials: M
authors.lastname: Gomez
authors.forename: D
authors.initials: D
authors.lastname: Schouten
authors.forename: J
authors.initials: J
authors.lastname: Fish
authors.forename: W
authors.initials: W
authors.lastname: Peters
authors.forename: A S
authors.initials: AS
authors.lastname: Slutsky
authors.forename: T E
authors.initials: TE
authors.lastname: Stewart
mesh_terms: D018806:APACHE; D000328:Adult; D000367:Age Factors; D002059:Burns, Inhalation / Q000150:complications*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000401:mortality* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors