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==Overview==
==Overview==
ARDS usually develops within 24 to 48 hours of the initial [[injury]] or [[illness]] and typically progresses over the course of 1 to 2 weeks (refer to [[Acute respiratory distress syndrome pathophysiology|'''Pathophysiology of ARDS''']). Failure to diagnose and treat ARDS early on is associated with a high [[mortality rate]] and may result in lifelong [[complications]] among survivors.
ARDS usually develops within 24 to 48 hours of the initial [[injury]] or [[illness]] and typically progresses over the course of 1 to 2 weeks (please refer to [[Acute respiratory distress syndrome pathophysiology|'''Pathophysiology of ARDS''']] for a discussion of this topic in greater detail). Failure to diagnose and treat ARDS early on is associated with a high [[mortality rate]] and may result in lifelong [[complications]] among survivors.


==Natural History==
==Natural History==

Revision as of 11:54, 25 June 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Brian Shaller, M.D. [2]

Overview

ARDS usually develops within 24 to 48 hours of the initial injury or illness and typically progresses over the course of 1 to 2 weeks (please refer to Pathophysiology of ARDS for a discussion of this topic in greater detail). Failure to diagnose and treat ARDS early on is associated with a high mortality rate and may result in lifelong complications among survivors.

Natural History

The first signs of ARDS typically present within 24 to 48 hours of the precipitating illness or injury and progress over the course of 1 to 2 weeks. The early clinical features of ARDS include:

Left untreated, the mortality rate from ARDS is estimated to be upwards of 70%.[1]

Complications

Long-term sequelae of ARDS are common, however, they are more likely to develop among those who do not receive early or adequate treatment. They include:

The most common complications of ARDS are those associated with a prolonged ICU stay:

Prognosis

Prognosis for patients with ARDS varies based on the severity of illness, the [[Acute respiratory distress syndrome causes|precipitating insult}}, and medical comorbidities:

  • The ARDS Definition Task Force calculated 90-day morality rates for mild, moderate, and severe ARDS as 27%, 32%, and 45%, respectively[2]
  • The 1-year mortality rate for patients with ARDS who survive to hospital discharge varies widely between different studies and is estimated to be anywhere from 11% to over 40%[3][4][5]
  • One study of patients diagnosed with ARDS in Maryland, United States, from 1992 through 1995 calculated an in-hospital mortality rate of 36% to 52%[1]
  • The mortality rate among patients with ARDS due to trauma appears to be lower than among patients with ARDS due to sepsis[6]

References

  1. 1.0 1.1 Reynolds HN, McCunn M, Borg U, Habashi N, Cottingham C, Bar-Lavi Y (1998). "Acute respiratory distress syndrome: estimated incidence and mortality rate in a 5 million-person population base". Crit Care. 2 (1): 29–34. doi:10.1186/cc121. PMC 28999. PMID 11056707.
  2. ARDS Definition Task Force. Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E; et al. (2012). "Acute respiratory distress syndrome: the Berlin Definition". JAMA. 307 (23): 2526–33. doi:10.1001/jama.2012.5669. PMID 22797452.
  3. Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, Diaz-Granados N, Al-Saidi F; et al. (2003). "One-year outcomes in survivors of the acute respiratory distress syndrome". N Engl J Med. 348 (8): 683–93. doi:10.1056/NEJMoa022450. PMID 12594312.
  4. Linko R, Suojaranta-Ylinen R, Karlsson S, Ruokonen E, Varpula T, Pettilä V; et al. (2010). "One-year mortality, quality of life and predicted life-time cost-utility in critically ill patients with acute respiratory failure". Crit Care. 14 (2): R60. doi:10.1186/cc8957. PMC 2887181. PMID 20384998.
  5. Wang CY, Calfee CS, Paul DW, Janz DR, May AK, Zhuo H; et al. (2014). "One-year mortality and predictors of death among hospital survivors of acute respiratory distress syndrome". Intensive Care Med. 40 (3): 388–96. doi:10.1007/s00134-013-3186-3. PMC 3943651. PMID 24435201.
  6. Sheu CC, Gong MN, Zhai R, Chen F, Bajwa EK, Clardy PF; et al. (2010). "Clinical characteristics and outcomes of sepsis-related vs non-sepsis-related ARDS". Chest. 138 (3): 559–67. doi:10.1378/chest.09-2933. PMC 2940067. PMID 20507948.


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