An Expanded Definition of the Adult Respiratory Distress Syndrome

Murray, John F.; Matthay, Michael A.; Luce, John M.; Flick, Michael R.

doi:10.1164/ajrccm/138.3.720

Cited by 2,296 publications

(1,225 citation statements)

References 9 publications

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“…Thirty-one patients with ARDS (19 male, 12 female; median age 37 yrs, range 18±66 yrs, 14 never, nine current and eight exsmokers; 22 survivors and nine nonsurvivors) who met the diagnostic criteria of the American/European Consensus [1], and had severe lung injury according to the Murray lung injury score [2] were investigated. The onset of injury was associated with bacterial or viral pneumonia in 10 patients (four of whom also had sepsis), sepsis alone in three, cardiopulmonary bypass surgery in six (one of whom also had sepsis), other major surgery in four (one of whom also had sepsis), major trauma due to road traffic accidents in five, pancreatitis in one, aspiration pneumonia in one and smoke inhalation in one.…”

Section: Study Groupsmentioning

confidence: 99%

“…The total standard input was achieved in the controls, but in the severely ill ARDS patients instillation was aborted if falls in oxygenation caused clinical concern; thus the introduction volumes were lower in most cases (table 1). The proportions of the fluid recovered were also significantly lower in the patient group compared to the healthy controls (table 1), presumably due to the substantial increase in lung permeability that is characteristic of this syndrome [1,2]. The BAL fluid was centrifuged at 1606g for 10 min at 48C to sediment the cells, and the supernatant divided into aliquots, frozen and stored at -708C in the presence of 1.8 mg .…”

Section: Bronchoalveolar Lavage and Study Protocolmentioning

confidence: 99%

“…During the first week, enough samples were available to undertake statistical analysis to determine whether any differences could be identified between the survivors and nonsurvivors. The prognostic value of the [2] or #26.7 according to BERNARD et al [1]. All patients fulfilled one of these criteria at some time during their illness.…”

Section: Bronchoalveolar Lavage and Study Protocolmentioning

confidence: 99%

“…Acute respiratory distress syndrome (ARDS) can develop in many serious conditions including sepsis, pneumonia, traumatic injury and major surgery [1,2]. Mortality is >40% and there is no effective therapy apart from supportive measures [2].…”

mentioning

confidence: 99%

“…Mortality is >40% and there is no effective therapy apart from supportive measures [2]. The initiating factors trigger an acute systemic inflammatory response which causes microvascular damage leading to increased pulmonary vascular permeability, interstitial and alveolar oedema, and hypoxaemic respiratory failure [1,2].…”

mentioning

confidence: 99%

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G-CSF and IL-8 but not GM-CSF correlate with severity of pulmonary neutrophilia in acute respiratory distress syndrome

Aggarwal¹,

Cs²,

Evans³

et al. 2000

Eur Respir J

177

124

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Activated neutrophils play a major role in the pathogenesis of acute respiratory distress syndrome (ARDS), and persistence of pulmonary neutrophilia is related to poor survival. Interleukin (IL)‐8 is implicated in recruiting neutrophils to the lungs but it has been postulated that granulocyte‐macrophage colony‐stimulating factor (GM‐CSF) and granulocyte colony‐stimulating factor (G‐CSF), which can promote the survival of neutrophils by delaying apoptosis, may prolong the inflammatory response. The aim of this study was to investigate the levels of GM‐CSF and G‐CSF in the lungs of patients with ARDS and determine their relationship relative to IL‐8 with levels of neutrophils and clinical outcome. The lungs of 31 patients with ARDS were sampled by means of bronchoalveolar lavage (BAL) and assays of the three cytokines were conducted via enzyme‐linked immunosorbent assay. GM‐CSF, G‐CSF and IL‐8 were all increased in the patients compared to healthy controls but concentrations of GM‐CSF were much lower than those of G‐CSF and IL‐8 (GM‐CSF

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Section: Study Groupsmentioning

confidence: 99%

Section: Bronchoalveolar Lavage and Study Protocolmentioning

confidence: 99%

Section: Bronchoalveolar Lavage and Study Protocolmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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G-CSF and IL-8 but not GM-CSF correlate with severity of pulmonary neutrophilia in acute respiratory distress syndrome

Aggarwal¹,

Cs²,

Evans³

et al. 2000

Eur Respir J

177

124

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Determinants of Short- and Long-term Outcome in Patients With Respiratory Failure Caused by AIDS-Related Pneumocystis carinii Pneumonia

Forrest¹,

Zala²,

Djurdjev³

et al. 1999

Arch Intern Med

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Objectives: To determine (1) predictors of in-hospital mortality and long-term survival in patients with acute respiratory failure (ARF) caused by acquired immunodeficiency syndrome-related Pneumocystis carinii pneumonia (PCP) and (2) long-term survival for patients with ARF relative to those without ARF.Methods: A retrospective medical chart review was conducted of all cases of PCP-related ARF for which the patient was admitted to the intensive care unit of a single tertiary care institution between 1991 and 1996. Data were extracted regarding physiologic scores, relevant laboratory values, and duration of previous maximal therapy with combined anti-PCP agents and corticosteroids at entry to the intensive care unit. Duration of survival was determined by Kaplan-Meier methods from date of first hospital admission and compared for patients with and without ARF.Results: There were 41 admissions to the intensive care unit among 39 patients, with 56.4% in-hospital mortality. Higher physiologic scores (Acute Physiology and Chronic Health Evaluation II [APACHE II], Acute Lung Injury, and modified Multisystem Organ Failure scores) were predictive of in-hospital mortality. Duration of previous maximal therapy also predicted in-hospital mortality (45% for patients with Ͻ5 days of previous maximal therapy vs 88% for those with Ն5 days of previous maximal therapy; P = .03). Combining physiologic scores and duration of previous maximal therapy enhanced prediction of in-hospital mortality. There was no difference in long-term survival between patients with PCP with ARF and those without ARF (P = .80), and baseline characteristics did not predict long-term survival.Conclusions: In-hospital mortality of patients with acquired immunodeficiency syndrome-related PCP and ARF is predicted by duration of previous maximal therapy and physiologic scores, and their combination enhances predictive accuracy. Long-term survival of patients with ARF caused by PCP is comparable to that of patients with PCP who do not develop ARF, and determinants of in-hospital mortality do not predict longterm survival. Med. 1999;159:741-747 Arch Intern

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The Sepsis Syndrome in a Dutch University Hospital

Kieft¹

1993

Arch Intern Med

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An Expanded Definition of the Adult Respiratory Distress Syndrome

Cited by 2,296 publications

References 9 publications

G-CSF and IL-8 but not GM-CSF correlate with severity of pulmonary neutrophilia in acute respiratory distress syndrome

G-CSF and IL-8 but not GM-CSF correlate with severity of pulmonary neutrophilia in acute respiratory distress syndrome

Determinants of Short- and Long-term Outcome in Patients With Respiratory Failure Caused by AIDS-Related Pneumocystis carinii Pneumonia

The Sepsis Syndrome in a Dutch University Hospital

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