Long-term assessment of lung function in survivors of severe ARDS.
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.
Neff
Thomas A
TA
Institute of Anesthesiology, University Hospital Zurich, Switzerland.
Stocker
Reto
R
Frey
Hans-Rudolf
HR
Stein
Sonja
S
Russi
Erich W
EW
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