Abstract
Despite improvements in critical care, acute respiratory distress syndrome (ARDS) remains a devastating clinical problem with high rates of morbidity and mortality. A better understanding of the prognostic factors associated with ARDS is crucial for facilitating risk stratification and developing new therapeutic interventions that aim to improve clinical outcomes. In this article, we present an up-to-date summary of factors that predict mortality in ARDS in four categories: (1) clinical characteristics; (2) physiological parameters and oxygenation; (3) genetic polymorphisms and biomarkers; and (4) scoring systems. In addition, we discuss how a better understanding of clinical and basic pathogenic mechanisms can help to inform prognostication, decision-making, risk stratification, treatment selection, and improve study design for clinical trials.
Highlights
The acute respiratory distress syndrome (ARDS) is a devastating syndrome of pulmonary inflammation and edema manifested clinically by the acute onset of bilateral infiltrates on chest radiograph, and arterial hypoxemia [1,2,3]
Discovery of prognostic factors for ARDS has enriched our understanding of the pathogenesis of this complex clinical syndrome and has impacted clinical trial design, risk assessment and accurate diagnosis of the syndrome
We categorized the prognostic factors into four areas including (1) clinical characteristics (2) physiological parameters and oxygenation (3) genetic polymorphisms and biomarkers (4) scoring systems
Summary
The acute respiratory distress syndrome (ARDS) is a devastating syndrome of pulmonary inflammation and edema manifested clinically by the acute onset of bilateral infiltrates on chest radiograph, and arterial hypoxemia [1,2,3]. Multicenter study of 452 ARDS patients with PaO2/FiO2 measured on standard ventilator settings of volume assist/ control mode, tidal volume 7 ml/kg PBW, inspiratory: expiratory time ratio (I:E)
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