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Intensive Care Med. 1999 Nov;25(11):1231-6.

ARDS in patients with thermal injury.

Author information

1
Division of Respiratory Medicine, Mt. Sinai Hospital, University of Toronto, Ontario, Canada.

Abstract

OBJECTIVE:

To determine the time to onset of the adult respiratory distress syndrome (ARDS) in patients with thermal injury requiring mechanical ventilation. Secondarily, to consider the burn-related risk factors, demographics, incidence, and mortality for ARDS in this population.

DESIGN:

Retrospective chart review; ARDS defined according to the American-European Consensus Conference and the Lung Injury Severity Score definitions.

SETTING:

Regional, tertiary referral, adult burn unit in a university teaching hospital.

PATIENTS AND PARTICIPANTS:

Patients with thermal injury requiring mechanical ventilation, admitted between 1 January 1991 and 28 February 1995.

INTERVENTIONS:

None.

MEASUREMENTS AND RESULTS:

Of 469 consecutive admissions, 126 (26.9%) received intubation and mechanical ventilation. ARDS was defined according to the American-European Consensus and Lung Injury Severity Score (score > 2.5) definitions. The mean time to onset of ARDS from admission to the burn unit was 6.9 +/- 5.2 and 8.2 +/- 10.7 days when defined by the American-European Consensus and Lung Injury Severity Score definitions respectively (p = 0.41). Of the intubated patients, 53.6 and 45.2% developed ARDS according to the American-European Consensus and Lung Injury Severity Score definitions, respectively (p = 0.19). Using multivariate logistic analysis, only age proved to be an independent risk factor for the development of ARDS (p = 0.03), although there was a trend toward an increased incidence of inhalation injury in patients with ARDS. Mortality was not significantly greater (41.8 vs 32.2%) in those with ARDS compared to those without (p = 0.27).

CONCLUSIONS:

According to the American-European Consensus Conference and the Lung Injury Severity Score definitions, ARDS is common in the adult burn population and has a delayed onset compared to most critical care populations. We found age to be a major predisposing factor for ARDS.

PMID:
10654206
[Indexed for MEDLINE]

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