Abstract
Objective: The aim of the study was to assess the incidence, clinical characteristics, etiology, risk factors, the impact of the number of quadrants involved and outcomes of VOP CAP patients with ARDS.
Methods: Prospective observational cohort study of consecutive adult patients with CAP admitted to the ICU that received either invasive (IMV) or non-invasive mechanical ventilation (NIMV) during the first 24 hours of hospital admission. We exclude patients with severe immunosuppression or active tuberculosis. ARDS diagnosis was based on the new Berlin definition. Chest-X-ray involvement was analyzed according to the number of quadrants involved.
Results: The study population comprised 102 VOP treated in ICU with either IMV (64 cases [63%]) or NIMV (38 cases [37%]). 27 patients (27%) met the Berlin ARDS criteria, and 75 cases (74%) did not. According to the severity classification based on the baseline PaO2/FiO2 ratio, 9 (35%), 13 (50%), and 4 (15%) patients had mild, moderate, and severe ARDS, respectively. Seventy-two (84%) non-ARDS patients presented unilateral infiltrates (1 quadrant 84%; 2 quadrants 12%). ICU mortality, 30-day mortality, and one-year mortality were significantly higher in the ARDS group (p<0.05). Patients with unilateral infiltrates have lower severity than patients with ARDS Multivariable analyses showed that ARDS patients showed an increased risk of death in in-hospital, ICU, 30-day and one-year mortality compared to non-ARDS patients.
Conclusion: ARDS developed in 24% of very old CAP patients treated in ICU with either IMV or NIMV. ARDS was associated with significantly higher risk of both short-term and long-term mortality.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA1741.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021