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Clinical Investigations in Critical CareLong-term Assessment of Lung Function in Survivors of Severe ARDSa
Section snippets
Materials and Methods
Between 1992 and 1994, 1,394 patients were admitted to our trauma surgical ICU and registered in a central ICU database. In 1995, this patient database was used to identify patients with ARDS or other lung-related problems. In a second step, the original patient records were screened. Only patients who retrospectively met the diagnostic criteria for ARDS as defined by the American-European Consensus Conference on ARDS in 19946 and who additionally showed a lung injury score (LIS) of > 2.5 as
Results
Mean interval between hospital discharge and follow-up examination was 29.5 ± 8.7 months (range, 15.0 to 40.7 months). The mean age of the study population at the time of functional assessment was 43.0 ± 14.1 years. Nine patients (56%) were smokers before onset of ARDS. Six patients (67%) resumed smoking, while the remaining three patients (33%) did not resume smoking after recovery, and seven patients (44%) remained nonsmokers.
Discussion
Clinical studies focusing on ARDS have most commonly been performed during the acute phase or within the first months after recovery. Less data are available on lung function during long-term follow-up of ARDS survivors. Residual impairment has been investigated by several groups since the beginning of the 1980s and seems to be common. Between 1972 and 2001, 30 studies and case reports including up to 51 patients have been published. The longest elapse of lung function testing after ARDS ranged
Conclusion
We conclude that residual obstructive and restrictive defects as well as an impaired gas exchange remain common up to 3 years after ARDS. Furthermore, our data confirm that CPET is a very sensitive measure to evaluate residual impairment of lung function after severe ARDS and show that impaired pulmonary gas exchange can be detected in many patients with normal Dlco.
Acknowledgment
We thank Professor Peter A. Ward, Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, for linguistic advice.
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