Acute lung injury/acute respiratory distress syndrome: a need for education.
OBJECTIVE
To examine the timeliness of the diagnosis of patients with ALI/ARDS at the San Juan VA Medical Intensive Care Unit. We were also interested in determining the incidence and the overall 28-day mortality for ARDS during the study period.


METHODS
Retrospective record review of all admissions to the San Juan Veterans Affairs Medical ICU during a two-year period (1997-1998).


RESULTS
During the study period, 587 patients were admitted to the medical ICU. All had APACHE II scoring performed during their first 24 hours of admission. Twenty-three patients were found to have an A-a gradient of 350 or less. However, two patients were later identified as having radiographic changes compatible with Congestive Heart Failure and were excluded from the study. The incidence of ALI/ARDS was found to be 3.6% at our institution. Of the 21 patients with ARDS, in only 4 the diagnosis of ARDS was documented on their charts.


CONCLUSIONS
Our findings suggest that education in the recognition of ARDS should be aggressively done. In order to implement the recently published successful strategies in the mechanical ventilation of patients with ARDS, it should be first recognized. Our patients need it.
Cedeño
Arturo
A
Pulmonary and Critical Care Medicine Section, San Juan Veterans Affairs Medical Center, 10 Casia St., San Juan, Puerto Rico 00921-3201.
Galera
Angel
A
Torres
Alfonso
A
Rodríguez-Cintrón
William
W
D018806:APACHE; D000328:Adult; D000368:Aged; D002983:Clinical Competence; D006801:Humans; D008297:Male; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000175:diagnosis*; D012189:Retrospective Studies