Acute Respiratory Distress Syndrome following Cardiac Surgery: Comparison of the American-European Consensus Conference Definition versus the Berlin Definition.


Journal

Respiration; international review of thoracic diseases
ISSN: 1423-0356
Titre abrégé: Respiration
Pays: Switzerland
ID NLM: 0137356

Informations de publication

Date de publication:
Historique:
received: 03 01 2018
accepted: 15 11 2018
pubmed: 17 1 2019
medline: 29 9 2020
entrez: 17 1 2019
Statut: ppublish

Résumé

Lung injury with development of the acute respiratory distress syndrome (ARDS) is a serious complication which can occur after major surgery, including cardiac surgery. The aim of our study was to compare the prevalence, risk factors, and mortality of ARDS following cardiac surgery according to the American-European Consensus Conference (AECC) definition and the new Berlin definition of ARDS. We performed a retrospective, observational study that included prospectively collected data from consecutive adult patients, aged from 18 to 92 years, who had undergone cardiac surgery (both on and off pump) at a large tertiary university hospital over 5 years (from September 2012 to September 2017). During the study period, 3,972 patients underwent cardiac surgery, and 3,946 patients were included in the study. Fifty-five patients developed ARDS (1.14%) according to the AECC definition and 59 patients (1.15%) according to the Berlin definition, with a mortality of 32.7 and 30.5%, respectively (18 patients). Multivariate regression analysis identified prior cardiac surgery, complex cardiac surgery, emergency procedures, and transfusion of > 3 packed red blood cell units as predictors for ARDS. The development of ARDS in patients after cardiac surgery is a rare but serious complication associated with significant mortality. Moreover, our findings showed that prevalence, mortality, and risk factors for developing ARDS were similar according to both the AECC and the new Berlin definition.

Sections du résumé

BACKGROUND BACKGROUND
Lung injury with development of the acute respiratory distress syndrome (ARDS) is a serious complication which can occur after major surgery, including cardiac surgery.
OBJECTIVE OBJECTIVE
The aim of our study was to compare the prevalence, risk factors, and mortality of ARDS following cardiac surgery according to the American-European Consensus Conference (AECC) definition and the new Berlin definition of ARDS.
METHODS METHODS
We performed a retrospective, observational study that included prospectively collected data from consecutive adult patients, aged from 18 to 92 years, who had undergone cardiac surgery (both on and off pump) at a large tertiary university hospital over 5 years (from September 2012 to September 2017).
RESULTS RESULTS
During the study period, 3,972 patients underwent cardiac surgery, and 3,946 patients were included in the study. Fifty-five patients developed ARDS (1.14%) according to the AECC definition and 59 patients (1.15%) according to the Berlin definition, with a mortality of 32.7 and 30.5%, respectively (18 patients). Multivariate regression analysis identified prior cardiac surgery, complex cardiac surgery, emergency procedures, and transfusion of > 3 packed red blood cell units as predictors for ARDS.
CONCLUSION CONCLUSIONS
The development of ARDS in patients after cardiac surgery is a rare but serious complication associated with significant mortality. Moreover, our findings showed that prevalence, mortality, and risk factors for developing ARDS were similar according to both the AECC and the new Berlin definition.

Identifiants

pubmed: 30650409
pii: 000495511
doi: 10.1159/000495511
doi:

Types de publication

Comparative Study Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

518-524

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2019 S. Karger AG, Basel.

Auteurs

Alexander Kogan (A)

Department of Cardiac Surgery, Sheba Medical Center (affiliated to the Sackler School of Medicine, Tel Aviv University), Tel Hashomer, Israel, alexanderkogan140@hotmail.com.

Michael J Segel (MJ)

Pulmonology Institute, Sheba Medical Center (affiliated to the Sackler School of Medicine, Tel Aviv University), Tel Hashomer, Israel.

Eilon Ram (E)

Department of Cardiac Surgery, Sheba Medical Center (affiliated to the Sackler School of Medicine, Tel Aviv University), Tel Hashomer, Israel.

Ehud Raanani (E)

Department of Cardiac Surgery, Sheba Medical Center (affiliated to the Sackler School of Medicine, Tel Aviv University), Tel Hashomer, Israel.

Yael Peled-Potashnik (Y)

Heart Institute, Sheba Medical Center (affiliated to the Sackler School of Medicine, Tel Aviv University), Tel Hashomer, Israel.

Shany Levin (S)

Department of Cardiac Surgery, Sheba Medical Center (affiliated to the Sackler School of Medicine, Tel Aviv University), Tel Hashomer, Israel.

Leonid Sternik (L)

Department of Cardiac Surgery, Sheba Medical Center (affiliated to the Sackler School of Medicine, Tel Aviv University), Tel Hashomer, Israel.

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