title: Long-term assessment of lung function in survivors of severe ARDS.
abstract: OBJECTIVE
  To investigate the long-term outcome of lung function in survivors of severe ARDS after modern treatment strategies including lung protective mechanical ventilation and prone positioning maneuvers.
  
  
  METHODS
  Follow-up cohort study.
  
  
  METHODS
  University hospital pulmonary division and level 1 trauma center.
  
  
  METHODS
  Sixteen survivors of severe ARDS (from 1992 to 1994) with a lung injury score > or = 2.5.
  
  
  METHODS
  The follow-up study (from 1995 to 1996) included interview, physical examination, chest radiographs, static and dynamic lung volumes, diffusion capacity of the lung for carbon monoxide (DLCO), blood gas analysis, and cardiopulmonary exercise testing (CPET).
  
  
  RESULTS
  The mean +/- SD interval between hospital discharge and functional assessment was 29.5 +/- 8.7 months (range, 15.0 to 40.7 months). In approximately one half of the patients, mild abnormalities in static and dynamic lung volumes were found. In 25% (4 of 16 patients), lung function was obstructive; in 25% (4 of 16 patients), lung function was restrictive; and in 6.3% (1 of 16 patients), a combined obstructive-restrictive pattern was revealed. DLCO was impaired in 12.5% (2 of 16 patients); gas exchange during exercise was impaired in 45.5% (5 of 11 patients).
  
  
  CONCLUSIONS
  Residual obstructive and restrictive defects as well as impaired pulmonary gas exchange remain common after severe ARDS. CPET is a very sensitive measure to evaluate residual impairment of lung function after ARDS. Using CPET, reduced pulmonary gas exchange can be detected in many patients with normal DLCO.
authors.affiliation: Institute of Anesthesiology, University Hospital Zurich, Switzerland.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Neff
authors.forename: Reto
authors.initials: R
authors.lastname: Stocker
authors.forename: Hans-Rudolf
authors.initials: HR
authors.lastname: Frey
authors.forename: Sonja
authors.initials: S
authors.lastname: Stein
authors.forename: Erich W
authors.initials: EW
authors.lastname: Russi
mesh_terms: D000328:Adult; D004417:Dyspnea / Q000209:etiology; D005080:Exercise Test; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011659:Pulmonary Gas Exchange; D012123:Pulmonary Ventilation; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D012129:Respiratory Function Tests; D017741:Survivors; D016896:Treatment Outcome