The adult respiratory distress syndrome (ARDS) is a form of diffuse lung injury associated with multiple risk factors. Patients with severe hypoxemia who meet blood gas criteria defined by the extracorporeal membrane oxygenation trial (ECMO) of 1974 to 1977 have a reported survival of 11 percent. The reported survival has remained unchanged for 15 years despite numerous technologic advances. We prospectively studied ARDS patients who met ECMO blood gas criteria. One hundred seventy-eight ARDS patients were prospectively screened over a 30-month period. Fifty-one of these patients met ECMO blood gas criteria and 23 (45 percent) survived (p less than 0.001 vs ECMO trial). No obvious differences in etiology, APACHE II score, organ system failure, or the incidence of sepsis was found between survivors and nonsurvivors. We conclude that survival of ARDS patients who met ECMO blood gas criteria in our institution is higher than that previously reported from both other centers and our own hospital.

译文

成人呼吸窘迫综合征 (ARDS) 是一种与多种危险因素相关的弥漫性肺损伤。符合体外膜氧合试验 (ECMO) 1974年定义的血气标准的严重低氧血症患者1977年的生存率为11%。尽管有许多技术进步,但报告的生存率仍保持15年不变。我们前瞻性地研究了符合ECMO血气标准的ARDS患者。在30个月的时间内,对78名ARDS患者进行了前瞻性筛查。这些患者中有51名符合ECMO血气标准,23名 (45% 名) 存活 (与ECMO试验相比,p小于0.001)。幸存者和非幸存者在病因,APACHE II评分,器官系统衰竭或败血症发生率方面没有明显差异。我们得出的结论是,在我们机构中符合ECMO血气标准的ARDS患者的生存率高于其他中心和我们自己的医院先前报告的生存率。

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