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

Abstract

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.

Two-Year Cognitive, Emotional, and Quality-of-Life Outcomes in Acute Respiratory Distress Syndrome

“…The quality of life in our ARDS survivors was significantly lower than the normal population, and was similar to previous reports in other ARDS patients (9,10,(12)(13)(14)(15)73). We found three distinct patterns for the SF-36 domains in our ARDS patients from hospital discharge to 2 years after discharge.…”

Acute Lung Injury and Fibrosis in a Baboon Model of Escherichia coli Sepsis

“…Furthermore, patients with ARDS with fatal outcome show higher TGF-b1 concentrations than the survivors (45). These results suggest that high TGF-b1 levels play a relevant role in the pathogenesis of persistent sepsis-induced ARDS (46).…”

“…The higher incidence of fibrosis in our model versus human patients probably reflects the greater sensitivity of immunohistochemical measurements compared with physiological assessment. Moreover, survivors of sepsis-induced ARDS have a lower rate of functional recovery than survivors of other types of ARDS (46).…”

Mobile, awake and critically ill

“…These decrements in quality of life may persist for years and may be irreversible in some cases. [2][3][4][5][6][7][8] Contractures acquired during a prolonged ICU stay are another important contributor to decreased quality of life. Upper-extremity contractures can dramatically limit many essential activities of daily living, such as bathing, toileting and grooming, and lowerextremity contractures can limit walking or promote falling, and they may impede a patient's ability to return to work if his or her occupation is physically demanding.…”