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Clinical Investigations in Critical Care: ArticlesPulmonary Fibrosis Correlates With Outcome in Adult Respiratory Distress Syndrome: A Study in Mechanically Ventilated Patients
Section snippets
Clinical Data
This study was conducted in a medicosurgical ICU. Twenty-five consecutive patients with ARDS were prospectively included in the study. The protocol received approval from the Committee for the Protection of Human Subjects of our institution and informed consents were obtained from the patients' families. Adult respiratory distress syndrome was defined by the following criteria: (1) PaO2 less than 60 mm Hg with fraction of inspired oxygen (FIo2) of 0.5 or more; (2) bilateral diffuse infiltrates
Characteristics of the Patients
No lung specimen was obtained in three patients. Two of these patients died from multiple organ failure, and one was discharged from the hospital. Of the remaining 22 patients, 17 were men and 5 were women, with a mean age of 49.4±17 years. Simplified Acute Physiology Score was 12.4±3.3. Causes of ARDS were postsurgical complications in 7 patients, multiple trauma in 8 patients, and medical problems in the remaining 7 patients (neurological disorders, 3 patients; hematologic malignancy, 2
Discussion
In the present study, presence of histologic signs of pulmonary fibrosis significantly correlates with outcome in patients with established ARDS. Interstitial fibrosis occurs early in the course of ARDS. Hill et al3 showed that such abnormalities are found in half of their patients within the first 36 h of ARDS. This was confirmed by Costa Auler et al4 in patients with ARDS following cardiopulmonary bypass and by Ashbaugh and Maier5 in patients with ARDS from various origins. Zapol et al6 found
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2021, European Journal of PharmacologyCitation Excerpt :The prognosis of ARDS remains poor, with a mortality rate of 40% (Bellani et al., 2016). Fibrotic scarring is increasingly recognized as an important prognostic factor of ARDS: alveolar fibrosis is correlated with increased mortality in ARDS (Martin et al., 1995). Lung parenchymal fibroproliferation assessed by chest high-resolution computed tomography (HRCT) also predicts increased mortality in patients with ARDS (Ichikado et al., 2012).