title: Diagnosis of acute respiratory distress syndrome in nosocomial pneumonia.
abstract: Acute respiratory distress syndrome (ARDS) complicates nosocomial pneumonias (NPn) in 12% to 33% of patients with associated increases in mortality of up to 80%. A timely diagnosis of ARDS with NPn is, however, problematic. The aim of this investigation was to improve the diagnosis and treatment of the early stages of ARDS with NPn. A total of 82 cancer and multiple trauma patients were enrolled in the investigation. Patients were split into 3 groups according to standard ARDS and NPn diagnostic criteria: group 1 ("ARDS + NPn"), group 2 ("NPn"), group 3 ("no ARDS, no NPn"). ARDS was diagnosed using 3 methods: the Murray score, the American-European Consensus Conference criteria, and the V. A. Negovsky Research Institute of General Reanimatology criteria. Elevation of extravascular lung water index along with other ARDS diagnostic criteria (oxygenation index, central hemodynamic indices) was predictive of early stage of ARDS in patients with NPn. The standard diagnostic criteria for ARDS, including the Murray score, oxygenation index, and radiographic data only predicted the later stages of ARDS in NPn. Early diagnosis of ARDS with concomitant NPn in the current study was associated with improved treatment results with decreased duration of artificial ventilation and intensive care unit stay.
authors.affiliation: V.A. Negovsky Research Institute of General Reanimatology, Moscow, Russian Federation. artem_kuzovlev@mail.ru
authors.forename: Artem N
authors.initials: AN
authors.lastname: Kuzovlev
authors.forename: Viktor V
authors.initials: VV
authors.lastname: Moroz
authors.forename: Arkady M
authors.initials: AM
authors.lastname: Goloubev
authors.forename: Sergey G
authors.initials: SG
authors.lastname: Polovnikov
mesh_terms: D000328:Adult; D000368:Aged; D003422:Critical Care; D003428:Cross Infection; D015633:Extravascular Lung Water / Q000378:metabolism; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications*; D009369:Neoplasms / Q000150:complications*; D011014:Pneumonia / Q000150:complications*; D011237:Predictive Value of Tests; D012121:Respiration, Artificial / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D013997:Time Factors; D055815:Young Adult