Chest, Vol 76, 180-186, Copyright © 1979 by American College of Chest Physicians

ARTICLES

Evaluation of the progress and prognosis of adult respiratory distress syndrome. Simple respiratory physiologic measurement

Y Shimada, I Yoshiya, K Tanaka, S Sone and M Sakurai

In our study of 14 patients with adult respiratory distress syndrome (ARDS), we measured A-aDO2, VD/VT, arterial-to-end tidal PCO2 ), effective dynamic compliance, and pulmonary vascular resistance on a daily basis. At the onset of ARDS, all patients showed bilateral interstitial edema on the chest X-ray films, P(A-a)O2 of more than 500 mm Hg, marked decrease in effective dynamic compliance, a moderate increase in VD/VT, and a normal value of a-etPCO2. Pulmonary vascular resistance was low. After seven days, all of those who subsequently died and developed persistent elevation of P(A-a)O2, significant increase in VD/VT, a-etPCO2 and pulmonary vascular resistance, and significant decrease in effective dynamic compliance compared to the values at the onset of ARDS. Those abnormalities diverged significantly from the findings in those who survived. By evaluating sequential changes of those parameters, we might be able to predict an accurate prognosis of ARDS.

This article has been cited by other articles:

				U. Lucangelo, F. Bernabe, S. Vatua, G. Degrassi, A. Villagra, R. Fernandez, P. V. Romero, P. Saura, M. Borelli, and L. Blanch Prognostic Value of Different Dead Space Indices in Mechanically Ventilated Patients With Acute Lung Injury and ARDS Chest, January 1, 2008; 133(1): 62 - 71. [Abstract] [Full Text] [PDF]

				D. F. Szpisjak, C. L. Lamb, and K. D. Klions Oxygen Consumption with Mechanical Ventilation in a Field Anesthesia Machine Anesth. Analg., June 1, 2005; 100(6): 1713 - 1717. [Abstract] [Full Text] [PDF]

				J. A. Coss-Bu, D. L. Walding, Y. B. David, and L. S. Jefferson Dead Space Ventilation in Critically Ill Children With Lung Injury Chest, June 1, 2003; 123(6): 2050 - 2056. [Abstract] [Full Text] [PDF]