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Critical Care

, 5:P61 | Cite as

Multiple organ dysfuntion in ARDS

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

Keywords

Public Health Poor Prognosis Emergency Medicine Multiple Organ Organ Dysfunction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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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