[Treatment of acute respiratory distress syndrome in a treatment center. Success is dependent on risk factors].
METHODS
Mortality rates remain high for the acute respiratory distress syndrome (ARDS) despite standardised treatment algorithms. Little is known about prognostic factors and exclusion criteria for advanced treatment including extracorporeal membrane oxygenation (ECMO).


METHODS
In an observational study design a cohort of 93 patients with severe ARDS admitted to a referral centre were analysed according to ventilatory and vital parameters.


RESULTS
Overall survival rate was 70% and in patients who received ECMO treatment it was 67%. In patients exhibiting relevant co-morbidity the odds ratio for fatal outcome increased to 4.7 (95% CI: 3.3-24.9), and patients with multiple organ failure had a 7.5-fold increase (95% CI: 2.3-25.2) for risk of death. Survivors demonstrated a more pronounced improvement in oxygenation ( p<0.05) and CO(2) removal ( p<0.05) than non-survivors.


CONCLUSIONS
Advanced treatment of ARDS including ECMO represents a therapeutic option if none of the currently considered contraindications are present. An improvement in gas exchange parameters, but not a defined value per se may be useful as a prognostic factor for favourable outcome.
Klinik für Anästhesiologie, Universitätsklinikum Aachen. mail@d-henzler.de
D
D
Henzler
R
R
Dembinski
R
R
Kopp
R
R
Hawickhorst
R
R
Rossaint
R
R
Kuhlen
D000328:Adult; D000368:Aged; D000465:Algorithms; D002245:Carbon Dioxide / Q000378:metabolism; D015331:Cohort Studies; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000401:mortality / Q000628:therapy*; D012129:Respiratory Function Tests; D015656:Respiratory Mechanics; D013534:Survival; D014187:Transportation of Patients; D016896:Treatment Outcome
D002245:Carbon Dioxide