Critical Care

, 5:P61 | Cite as

Multiple organ dysfuntion in ARDS

  • FS Dias
  • N Almeida
  • IC Wawrzeniak
  • PB Nery
Meeting abstract
  • 680 Downloads

Keywords

Public Health Poor Prognosis Emergency Medicine Multiple Organ Organ Dysfunction 

Introduction

The multiple organ dysfunction syndrome (MODS) is a major cause of mortality in ARDS. However, there are few studies evaluating this relationship using new score systems for MODS.

Methods

All patients in the ICU who met American-European Consensus criteria for ARDS [1] between November 1998 and December 2000 were included in the analysis. Criteria for MODS were those proposed by Marshall et al [2]. Age, gender, APACHEII score and outcome were also evaluated. The patients were divided into survivors (SV) and nonsurvivors (NSV). The differences between groups were analyzed with t-test, ?2 and Mann-Whitney as indicated.

Results

There were 975 admissions to the ICU, of whom 64 (6.6%) presented ARDS criteria. The mean age was 35 ± 13 years and 54 ± 16 years (P < 0.001), and the APACHEII was 16.4 ± 3.3 and 20 ± 5.2 (P = 0.02) in SV and NSV, respectively. General mortality was 79% (n = 51), 39% (n = 20) in females and 61% (n = 31) in males (P = 0.066). The results of the MODS in SV and NSV are shown in the Table.

Table

  

Day

MODS

 

1

2

3

4

5

6

7

 

n

64

59

49

42

35

33

26

Total

SV

6.2 ± 2.2**

5.6 ± 2.5*

5.8 ± 3*

4.8 ± 2.5*

4.3 ± 2.4*

4.7 ± 3.1*

5.5 ± 3.2-

 

NSV

8.5 ± 3

9.3 ± 2.8

9.7 ± 2.8

9.5 ± 2.2

8.6 ± 2.8

9.9 ± 2.5

9.2 ± 3.6

CNS

SV

0

0.1 ± 0.5

0

0

0

0

0

 

NSV

0

0.2 ± 0.8

0

0

0

0.2 ± 0.9

0

Cardiovascular

SV

1.2 ± 1.2

1.3 ± 1.2

1.5 ± 1

1 ± 0.7-

0.7 ± 1.2**

1.5 ± 1.1

1.7 ± 1.2

 

NSV

1.8 ± 1.4

2.1 ± 1.3

2.1 ± 1

1.9 ± 1.2

1.8 ± 1.2

2.2 ± 1.1

1.6 ± 1.3

Pulmonary

SV

3.3 ± 0.5

2.4 ± 1-

2.4 ± 1-

2 ± 1.2-

2.3 ± 1.2

2.1 ± 1.2

2.3 ± 1.1

 

NSV

3.2 ± 0.7

3.1 ± 0.8

3.1 ± 0.9

2.7 ± 0.9

2.7 ± 1

2.6 ± 0.9

2.4 ± 0.8

Renal

SV

0.4 ± 0.5

0.5 ± 0.8-

0.4 ± 0.6**

0.2 ± 0.4*

0.1 ± 0.4*

0.2 ± 0.4*

0.2 ± 0.6**

 

NSV

0.8 ± 0.8

1 ± 0.9

1.1 ± 0.8

1.4 ± 0.9

1.4 ± 0.8

1.6 ± 1

1.4 ± 0.8

Hematologic

SV

0.8 ± 1.1-

1 ± 1.1-

1.3 ± 1.4

1.3 ± 1.5

0.8 ± 1.3

0.5 ± 1-

0.7 ± 1.4

 

NSV

1.8 ± 1.5

1.9 ± 1.3

2.1 ± 1.5

2.2 ± 1.6

1.6 ± 1.4

1.7 ± 1.4

1.8 ± 1.5

Hepatic

SV

0.5 ± 0.7

0.3 ± 0.6-

0.2 ± 0.4**

0.3 ± 0.6**

0.3 ± 0.5

0.4 ± 0.7**

0.5 ± 0.9**

 

NSV

1 ± 1.1

1.1 ± 1.2

1.3 ± 1.2

1.4 ± 1.3

1.2 ± 1.4

1.4 ± 1.2

2 ± 1.3

*P < 0.001; **P < 0.01; -P < 0.05.

Conclusion

The severity of MODS measured by a specific score is associated with increased mortality in ARDS. Advanced age, male gender and individual dysfunction of renal and hepatic systems were associated with a poor prognosis.

References

  1. 1.
    Am J Respir Crit Care Med 1994, 273: 306.Google Scholar
  2. 2.
    Crit Care Med 1995, 23: 1638-1652. 10.1097/00003246-199510000-00007Google Scholar

Copyright information

© The Author(s) 2001

Authors and Affiliations

  • FS Dias
    • 1
  • N Almeida
    • 1
  • IC Wawrzeniak
    • 1
  • PB Nery
    • 1
  1. 1.Hospital São Lucas da PUCRSPorto AlegreBrazil

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