Late Pulmonary Function in Survivors of Adult Respiratory Distress Syndrome

Jv, Richardson; Rw, Light; Tw, Baskin; Rb, George

doi:10.1097/00007611-197606000-00022

Cited by 15 publications

(6 citation statements)

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“…Patients who survive the acute respiratory distress syndrome are at risk for physical and neuropsychological complications of the lung injury itself, associated multiorgan dysfunction, and their long stay in the intensive care unit (ICU). Several investigators have evaluated morbidity among survivors using pulmonary-function tests, [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] neuropsychological and cognitive assessments, [22][23][24][25][26] and quality-of-life measures, [27][28][29][30][31] and most have indicated that there is persistent morbidity after discharge from the ICU. However, no study has prospectively performed individualized assessments of physiological, functional, and quality-of-life measures during the year after discharge from the ICU to ascertain the main determinants of functional disability.…”

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confidence: 99%

One-Year Outcomes in Survivors of the Acute Respiratory Distress Syndrome

et al. 2003

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One-Year Outcomes in Survivors of the Acute Respiratory Distress Syndrome

et al. 2003

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“…Previous investigators have reported that patients who survive the acute respiratory distress syndrome (ARCS) have abnormalities in lung function that resolve to some degree over time (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Indeed, prior studies have shown that these abnormalities may resolve as early as 6 mo after recovery from ARCS and that survivors generally have near-normal pulmonary function tests at 1 yr. However,the true rate of resolution of lung function abnormalities in ARCS survivors cannot be determined accurately from these studies because of limitations in their design-in particular, problems in patient selection, small study samples, and the failure to obtain repeated measures on the same cohort of patients at uniform time intervals after extubation.…”

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Recovery of function in survivors of the acute respiratory distress syndrome.

Mchugh

Milberg

Whitcomb

et al. 1994

Am J Respir Crit Care Med

237

117

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We performed a prospective cohort analysis to determine the rate and extent of improvement in pulmonary function abnormalities and self-perceived health for 1 yr after surviving an episode of the acute respiratory distress syndrome (ARDS). We also examined the effect of ARDS severity and etiology, age, and sex on functional recovery. Patients were recruited from the intensive care units of one hospital and followed at regular time intervals from extubation to 1 yr. Fifty-two of 82 eligible adult survivors (63%) consented to participate; 37 of 82 (45%) had at least two examinations, and 20 (24%) had complete follow-up. Risk factors for ARDS included sepsis (n = 12), trauma (n = 15), and other (n = 10). Pulmonary function and self-perceived health scores improved considerably in the first 3 mo after extubation, with only slight additional improvement at 6 mo. No further changes were evident at 1 yr. Patients with more severe ARDS had significantly lower pulmonary function tests than did other survivors throughout follow-up. These observations should be useful for clinical follow-up of ARDS survivors and provide specific information concerning the expected rate of functional recovery in these patients.

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“…24 16 (19%) had persistent radiographic abnormalities after at least three months. 9,11,12,[15][16][17][18][19]25,27,28 The advent of computed tomography (CT) of the chest contributed significantly to the understanding of the distribution of pathology in ARDS. 29,30 There is a case report of a patient with ARDS posttrauma who was evaluated by chest CT 4 months after the onset of ARDS and again 7 months after onset.…”

Section: Chest Imagingmentioning

confidence: 99%

“…The only information concerning follow-up arterial blood gas (ABG) analysis comes from small case series published in the 1970s and 1980s. 1,9,10,12,14,15,[17][18][19][20]25,27,28 All report adequate ventilation, with no descriptions of persistent hypercarbia. Although many report entirely normal ABGs, the most common abnormality is a widened (A-a) O 2 difference that worsens with exercise.…”

Section: Arterial Blood Gas Analysismentioning

confidence: 99%

“…Small studies that followed reported similar findings, as well as the presence of airflow obstruction in a group of patients, and persisting PFT abnormalities in a few more. 2,[9][10][11][12][13][14][15][16][17][18]20,27 In 1989, two studies that included the PFT data of 80 survivors of ARDS were published. Peters and associates included 39 of 47 survivors who had been prospectively identified in the acute phase.…”

Section: Pulmonary Function Testingmentioning

confidence: 99%

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Long-Term Outcomes After ARDS

Lee¹,

Hudson²

2001

Seminars in Respiratory and Critical Care Medicine

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Early reports of late outcomes among survivors of ARDS indicated that most patients improved dramatically after their intensive care unit stay, and few lived with residua of their once-severe pulmonary injury. Over the last decade, a collection of new studies with improved methodology and novel questions has improved our understanding of life after ARDS. After reviewing these newer investigations in the context of previously published literature, we have drawn several preliminary conclusions: (1) Long-term survival after hospital discharge is unaffected by ARDS, but is strongly affected by ARDS risk factor and comorbidities. (2) Respiratory symptoms after ARDS are more prevalent than previously indicated, but improve over the first 12 months of recovery. (3) Pulmonary function testing reveals marked impairment soon after ARDS. There is improvement over the first 6 months, with lingering mild decreases in lung volume and diffusing capacity in most patients. A small group of patients have severe impairment without improvement. (4) Quality of life, functional independence, and cognitive function are severely affected by ARDS, with dramatic improvement over the first year. Quality of life is lower than in matched critically ill controls. (5) Significant numbers of ARDS survivors suffer from posttraumatic stress syndrome. This is an exciting time for research in long-term outcomes of ARDS, with potential for future studies that validate these single-center hypotheses, explore their ramifications, and investigate the impacts of changing practices in the intensive care unit in the acute phase of ARDS.

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Late Pulmonary Function in Survivors of Adult Respiratory Distress Syndrome

Cited by 15 publications

References 0 publications

One-Year Outcomes in Survivors of the Acute Respiratory Distress Syndrome

One-Year Outcomes in Survivors of the Acute Respiratory Distress Syndrome

Recovery of function in survivors of the acute respiratory distress syndrome.

Long-Term Outcomes After ARDS

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