[The incidence and mortality of ARDS in Icelandic intensive care units 1988-1997].
OBJECTIVE
A retrospective analysis of the epidemiology and intensive care treatment of ARDS in Iceland during the 10 year period, 1988-1997 with observation of trends within the period.


METHODS
All ICU admissions in Iceland 1988-1997 were reviewed according to the American-European consensus conference criteria on ARDS to select patients with the diagnosis of ARDS i.e. bilateral pulmonary infiltrates, PaO(2)/FiO(2) <200 and excluding patients with signs of heart failure or a pulmonary capillary wedge pressure (PCWP) >18 mmHg. Data were collected on age, gender, length of stay, ventilator treatment and ventilatory modes, causes of ARDS and mortality.


RESULTS
A total of 220 patients with severe respiratory failure were found and 155 of them were diagnosed as having ARDS or an annual incidence of 15.5 cases/year or 5.9 cases/100.000/year. If reference population >15 years of age is used for calculation the incidence is 7.8 cases/100.000/year. Hospital mortality was 40%, mean length of ICU stay was 21 days, mean hospital length of stay 39 days. The incidence of ARDS increased during the period with a tendency to lower mortality rates. Mortality was significantly lower when pressure controlled ventilation was used, compared to volume controlled ventilation.


CONCLUSIONS
The incidence of ARDS in a well defined population of Iceland is lower than recent studies in USA and Europe have shown or 5.9 cases/100.00/year but is increasing. The mortality is 40% and shows a slight downward trend, which may be due to the use of lung protective ventilation.
Sigvaldason
Kristinn
K
Department of Intensive Care, Fossvogi, 108 Reykjavík, Iceland. krisig@landspitali.is
Thornormar
Katrín
K
Bergmann
Jón Bragi
JB
Reynisson
Kristbjoern
K
Magnúsdóttir
Helga
H
Stefánsson
Thornorsteinn Svoerfu'eth'ur
TS
Jónsson
Steinn
S
D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D010100:Oxygen / Q000097:blood; D011175:Positive-Pressure Respiration; D011669:Pulmonary Wedge Pressure; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies
D010100:Oxygen