DOI: 10.36347/sjams.2018.v06i04.061

Pages: 1677-1682

Acute respiratory distress syndrome (ARDS) is a clinical syndrome of severe dyspnea of rapid onset, hypoxemia and diffuse pulmonary infiltrates leading to respiratory failure. ARDS is associated with significant morbidity and mortality. A prospective study to evaluate the clinical features, etiology, factors influencing survivors and non survivors, predictors of outcome of patients with ARDS admitted in ICU of tertiary care hospital this study encompassed 100 cases of ARDS admitted to ICU as per AECC guidelines. Patients excluded were with cardiac failure, significant underlying lung disease, and age below 14 years. There were more males 52% than females 48% with a total mortality of 61 %. In the present study the main etiological factor for ARDS was infective 84%. Most common cause being sepsis 45(53%). ARDS due to noninfective cause accounted for 16% of cases. Sepsis with multiorgan failure was seen in 26% with mortality of 61.5%. APACHE II score among survivors was 12.3 ± 5.3 compared to non survivors 18.9 ± 5.7.APACHE III score among survivors was 53.6 ± 14.9 compared to non survivors 94.1 ±19.8. The PaO2/FiO2 at admission was109.9 ± 35.5 for survivors compared to 75.5 ± 36.3 for non survivors. Dengue, Malaria, pneumonia, scrub typhus and undiagnosed fever were the main etiologies. PaO2/ FiO2 ratio, APACHE II and III score at the time of admission were significant predictors of the outcome. Sepsis, acidosis, hypotension, and multiorgan failure were individual predictors of mortality in patients with ARDS.