10. tbl. 99.árg. 2013
The incidence and mortality of ARDS at Landspítali - The National University Hospital of Iceland 2004-2008
Brátt andnauðarheilkenni (ARDS) á gjörgæsludeildum Landspítala 2004-2008
Objective: A retrospective study of the incidence, causes, mortality and treatment of patients with ARDS at Landspítali- The National University Hospital of in Iceland during the five year period 2004-2008 and, comparing the results with an earlier study for the period 1988-1997.
Materials and methods: All ICU admissions during the period 2004-2008 were reviewed, selecting patients according to the American-European consensus criteria for ARDS. Data were collected on age, gender, causes, length of stay, ventilator treatment and survival.
Results: A total of 6413 patients were admitted to the ICU´s at Landspítali during the study period and 120 patients were found to have ARDS giving an incidence of 7,9/100.000 inhabitants. Average age was 55 years, 55% were males, length of stay was 13 days and hospital stay 24 days. ICU mortality was 30% and 90 day mortality was 39%.
Conclusion: The incidence of ARDS seems to have increased somewhat during from the period 1988-1997. Mortality has decreased significantly probably due to improvements in intensive care treatment, especially ventilator treament with the use of lung protective ventilation, high frequency oscillation, prone position and ECMO.
Key words: ARDS, ARDS incidence, lung protective ventilation, respiratory failure.
Correspondence: Kristinn Sigvaldason, krisig@landspitali.is
Gunnarsson ThS1), Sigvaldason K2), Reynisson KI3), Möller AD2)
1. University of Iceland, Department of Medicine,
2. Department of Anaesthesia and Intensive Care,
3 Department of Radiology, Landspítali- The National University Hospital, Reykjavík, Iceland.
Table I. Acute respiratory distress syndrome in Iceland 2004-2008
Annual incidence, age distribution and mortality compared with an earlier study 1988-1997. APACHE =acute physiologic and chronic health evaluation score. LIS=Lung Injury Scale. PaO2=arterial oxygen tension, FiO2=inspired oxygen fraction.
Table II. Acute respiratory distress syndrome, comparison of survivors and non-survivors
APACHE =acute physiologic and chronic health evaluation score. LIS=Lung Injury Scale.
PaO2=arterial oxygen tension, FiO2=inspired oxygen fraction.
Table III. Mechanical ventilation
APACHE =acute physiologic and chronic health evaluation score. PaO2=arterial oxygen tension, FiO2=inspired oxygen fraction. PEEP = Positive End Expiratory Pressure, PC = Pressure controlled ventilation, HFO = High Frequency Oscillatory Ventilation, VC = Volume controlled ventilation.
Table IV. The causes of Acute Respiratory Distress Syndrome
APACHE =acute physiologic and chronic health evaluation score. PaO2=arterial oxygen tension, FiO2=inspired oxygen fraction.
Figure 1. Chest radiogram of a patient suffering from ARDS showing extensive diffuse bilateral infiltrates.
Figure 2. Number of patients and time (days) from causative effect to confirmed ARDS.