Acute respiratory distress syndrome mimickers lacking common risk factors of the Berlin definition

Purpose Some patients presenting with acute respiratory failure and meeting the Berlin criteria for acute respiratory distress syndrome (ARDS) lack exposure to common risk factors (CRF). These so-called ARDS mimickers often lack histological diffuse alveolar damage. We aimed to describe such ARDS mi...

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Bibliographic Details
Published in:Intensive care medicine 2016-02, Vol.42 (2), p.164-172
Main Authors: Gibelin, Aude, Parrot, Antoine, Maitre, Bernard, Brun-Buisson, Christian, Mekontso Dessap, Armand, Fartoukh, Muriel, de Prost, Nicolas
Format: Article
Language:English
Subjects:
Acute respiratory distress syndrome
Aged
Aged, 80 and over
Anesthesiology
Cellular biology
Cohort Studies
Critical Care Medicine
Edema
Emergency Medicine
Female
France
France - epidemiology
Germany
Human health and pathology
Humans
Intensive
Intensive care
Lavage
Life Sciences
Male
Medical imaging
Medical prognosis
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Middle Aged
Mortality
Original
Pain Medicine
Pediatrics
Pneumology/Respiratory System
Pneumonia
Prevalence
Pulmonology and respiratory tract
Respiratory distress syndrome
Respiratory Distress Syndrome, Adult - diagnosis
Respiratory Distress Syndrome, Adult - epidemiology
Respiratory Distress Syndrome, Adult - therapy
Retrospective Studies
Risk Factors
Sepsis
Steroids
United Kingdom
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Summary:Purpose Some patients presenting with acute respiratory failure and meeting the Berlin criteria for acute respiratory distress syndrome (ARDS) lack exposure to common risk factors (CRF). These so-called ARDS mimickers often lack histological diffuse alveolar damage. We aimed to describe such ARDS mimickers lacking CRF (ARDS CRF− ) in comparison with others (ARDS CRF+ ). Methods Retrospective study including all patients receiving invasive mechanical ventilation for ARDS admitted to the intensive care units (ICUs) of two tertiary care centers from January 2003 to December 2012. Results The prevalence of ARDS CRF− was 7.5 % (95 % CI [5.5–9.5]; n  = 50/665). On the basis of medical history, bronchoalveolar lavage fluid cytology, and chest CT scan patterns, four etiological categories were identified: immune ( n  = 18; 36 %), drug-induced ( n  = 13; 26 %), malignant ( n  = 7; 14 %), and idiopathic ( n  = 12; 24 %). Although the ARDS CRF− patients had a lower logistic organ dysfunction score (4 [3–8] vs. 10 [6–13]; p  
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-015-4064-y