Impact of initial respiratory compliance in ventilated patients with acute respiratory distress syndrome related to COVID-19

The incidence of describing acute respiratory distress syndrome (ARDS) is approximately 23% in mechanically ventilated patients. The diagnosis of ARDS varies widely; studies report a variation in the population diagnosed with ARDS, from 10 to 86 cases per 100,000. Complications of mechanical ventilation are common and include ventilator-associated pneumonia (VAP), barotrauma from excessive airway pressures, and volutrauma from excessive tidal volumes which may both worsen ARDS. Pneumothorax occurs in some patients, necessitating the placement of chest drains. This chapter starts with describing ARDS and the Berlin Definition, and its incidence. It also covers aetiology and physiology, then goes on to its treatment and general management. This includes respiratory support, position changes, and other treatments. Situation-dependent prognoses are outlined. Specific nursing care is also described.

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Lung Injury Prediction Score Is Useful in Predicting Acute Respiratory Distress Syndrome and Mortality in Surgical Critical Care Patients

Critical Care Research and Practice ◽

10.1155/2015/157408 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Zachary M. Bauman ◽

Marika Y. Gassner ◽

Megan A. Coughlin ◽

Meredith Mahan ◽

Jill Watras

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Lung Injury ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Prediction Score ◽

Surgical Patients ◽

Surgical Intensive Care Unit ◽

Injury Prediction ◽

Ventilated Patients

Background. Lung injury prediction score (LIPS) is valuable for early recognition of ventilated patients at high risk for developing acute respiratory distress syndrome (ARDS). This study analyzes the value of LIPS in predicting ARDS and mortality among ventilated surgical patients.Methods. IRB approved, prospective observational study including all ventilated patients admitted to the surgical intensive care unit at a single tertiary center over 6 months. ARDS was defined using the Berlin criteria. LIPS were calculated for all patients and analyzed. Logistic regression models evaluated the ability of LIPS to predict development of ARDS and mortality. A receiver operator characteristic (ROC) curve demonstrated the optimal LIPS value to statistically predict development of ARDS.Results. 268 ventilated patients were observed; 141 developed ARDS and 127 did not. The average LIPS for patients who developed ARDS was8.8±2.8versus5.4±2.8for those who did not (p<0.001). An ROC area under the curve of 0.79 demonstrates LIPS is statistically powerful for predicting ARDS development. Furthermore, for every 1-unit increase in LIPS, the odds of developing ARDS increase by 1.50 (p<0.001) and odds of ICU mortality increase by 1.22 (p<0.001).Conclusion. LIPS is reliable for predicting development of ARDS and predicting mortality in critically ill surgical patients.

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