Recovery from lung injury in survivors of acute respiratory distress syndrome: difference between pulmonary and extrapulmonary subtypes.
OBJECTIVE
To determine whether long-term outcome differs between acute respiratory distress syndrome (ARDS) resulting from pulmonary (ARDSp) and extrapulmonary (ARDSexp) causes.


METHODS
Observational study.


METHODS
Medical intensive care unit of a university hospital.


METHODS
Twenty-nine ARDS patients (16 ARDSp and 13 ARDSexp) who survived over 6 months after diagnosis.


RESULTS
The two groups did not differ according to demographic data and severity indices on admission. The duration of ICU stay (median 21 days [interquartile range, 12-43 days] vs 12 [6.5-20] days, p=0.097) tended to be longer and total ventilation time (360 [96-700] h vs 144 [42.5-216] h, p=0.045) were longer in the patients with ARDSp. The ARDSp patients showed more severe abnormalities on thin-section computed tomography (CT), including ground-glass opacity (GGO; 6 [3-16] vs 0 [0-2.5], p=0.002), reticular density (12 [8-14] vs 5 [2-9], p=0.033) and the sum of all four patterns of lesion (20 [11-27] vs 5 [2-12], p=0.006). There were no between-group differences in Spitzer's Quality of Life index and the Chronic Respiratory Questionnaire.


CONCLUSIONS
These results suggest that ARDSp would leave more severe lung sequelae than ARDSexp, but the clinical relevance of their difference is questionable.
Kim
Sun Jong
SJ
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 138-736 Songpa-gu, Seoul, Korea.
Oh
Bum Jin
BJ
Lee
Jin Sung
JS
Lim
Chae-Man
CM
Shim
Tae Sun
TS
Lee
Sang Do
SD
Kim
Woo Sung
WS
Kim
Dong Soon
DS
Kim
Won Dong
WD
Koh
Younsuck
Y
D000368:Aged; D001784:Blood Gas Analysis; D006801:Humans; D007362:Intensive Care Units; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012128:Respiratory Distress Syndrome / Q000145:classification / Q000209:etiology* / Q000503:physiopathology*; D012129:Respiratory Function Tests; D016019:Survival Analysis; D017741:Survivors; D013997:Time Factors; D014057:Tomography, X-Ray Computed