Investigació Aplicada en Malalties Respiratòries

The study presents a systematic review of mortality due to ARDS between 1985 and 2006, with statistical analysis of the data using meta-regression studies.

This is shown in an international study published in the American Journal of Respiratory and Critical Care Medicine (AJRCCM). Mortality associated with ARDS has not fallen since 1994, when the definition of the disease was revised and agreed. The study was jointly led by Dr. Joan Ramon Badia of Hospital Clínic, Barcelona-IDIBAPS-CIBERES, with the participation of researchers from Canada, Australia, the UK and Singapore. The research was carried out over the sabbatical year for furthering studies spent by Dr. Badia in the Critical Care Medicine division of the University of Toronto.

ARDS is a pulmonary disease that hinders oxygen transfer to the bloodstream. It is caused by a lung lesion that leads to the accumulation of fluid and inflammatory mediators, reducing its ability to expand. The disease has an associated mortality of approximately 40% and has a significant incidence among patients admitted to ICUs.

In recent years, the general impression among the scientific community and intensive care was that advances in mechanical ventilation and understanding of the disease were resulting in a reduction of the associated mortality. The study presents a systematic review of ARDS-related mortality between 1985 and 2006, with statistical analysis of the data using meta-regression.

Analysis of the data provides solid evidence that has sparked debate, as it shows that mortality due to this disease has not fallen in recent years despite the apparent advances mentioned. It also shows that mortality is much lower in the carefully selected patients included in randomized studies, compared to the mortality found in prospective series of cases without exclusion criteria.

The results raise doubts about the real-world efficacy of the interventions evaluated using highly selected populations and about the rate of application of new knowledge to clinical practice. The researchers thus highlight the need to obtain a more thorough understanding of this syndrome as, even though life-support measures have improved, there is still no effective etiologic treatment.

author: http://blog.hospitalclinic.org