Acute respiratory distress syndrome in mechanically ventilated patients with community-acquired pneumonia

Catia Cilloniz, Miquel Ferrer, Adamanthia Liapikou, Carolina Garcia-Vidal, Albert Gabarrus, Adrian Ceccato, Jorge Puig de La Bellacasa, Francesco Blasi, Antoni Torres

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Our aim was to assess the incidence, characteristics, aetiology, risk factors and mortality of acute respiratory distress syndrome (ARDS) in intensive care unit (ICU) patients with community-acquired pneumonia (CAP) using the Berlin definition.We prospectively enrolled consecutive mechanically ventilated adult ICU patients with CAP over 20 years, and compared them with mechanically ventilated patients without ARDS. The main outcome was 30-day mortality.Among 5334 patients hospitalised with CAP, 930 (17%) were admitted to the ICU and 432 required mechanical ventilation; 125 (29%) cases met the Berlin ARDS criteria. ARDS was present in 2% of hospitalised patients and 13% of ICU patients. Based on the baseline arterial oxygen tension/inspiratory oxygen fraction ratio, 60 (48%), 49 (40%) and 15 (12%) patients had mild, moderate and severe ARDS, respectively. Streptococcus pneumoniae was the most frequent pathogen, with no significant differences in aetiology between groups. Higher organ system dysfunction and previous antibiotic use were independent risk factors for ARDS in the multivariate analysis, while previous inhaled corticosteroids were independently associated with a lower risk. The 30-day mortality was similar between patients with and without ARDS (25% versus 30%, p=0.25), confirmed by propensity-adjusted multivariate analysis.ARDS occurs as a complication of CAP in 29% of mechanically ventilated patients, but is not related to the aetiology or mortality.

Original languageEnglish
Article numberpii 1702215
JournalThe European respiratory journal
Volume51
Issue number3
DOIs
Publication statusPublished - Mar 1 2018

Fingerprint

Adult Respiratory Distress Syndrome
Pneumonia
Intensive Care Units
Mortality
Berlin
Multivariate Analysis
Oxygen
Severe Acute Respiratory Syndrome
Streptococcus pneumoniae
Artificial Respiration
Arterial Pressure
Adrenal Cortex Hormones
Anti-Bacterial Agents
Incidence

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Cilloniz, C., Ferrer, M., Liapikou, A., Garcia-Vidal, C., Gabarrus, A., Ceccato, A., ... Torres, A. (2018). Acute respiratory distress syndrome in mechanically ventilated patients with community-acquired pneumonia. The European respiratory journal, 51(3), [pii 1702215 ]. https://doi.org/10.1183/13993003.02215-2017

Acute respiratory distress syndrome in mechanically ventilated patients with community-acquired pneumonia. / Cilloniz, Catia; Ferrer, Miquel; Liapikou, Adamanthia; Garcia-Vidal, Carolina; Gabarrus, Albert; Ceccato, Adrian; Puig de La Bellacasa, Jorge; Blasi, Francesco; Torres, Antoni.

In: The European respiratory journal, Vol. 51, No. 3, pii 1702215 , 01.03.2018.

Research output: Contribution to journalArticle

Cilloniz, C, Ferrer, M, Liapikou, A, Garcia-Vidal, C, Gabarrus, A, Ceccato, A, Puig de La Bellacasa, J, Blasi, F & Torres, A 2018, 'Acute respiratory distress syndrome in mechanically ventilated patients with community-acquired pneumonia', The European respiratory journal, vol. 51, no. 3, pii 1702215 . https://doi.org/10.1183/13993003.02215-2017
Cilloniz, Catia ; Ferrer, Miquel ; Liapikou, Adamanthia ; Garcia-Vidal, Carolina ; Gabarrus, Albert ; Ceccato, Adrian ; Puig de La Bellacasa, Jorge ; Blasi, Francesco ; Torres, Antoni. / Acute respiratory distress syndrome in mechanically ventilated patients with community-acquired pneumonia. In: The European respiratory journal. 2018 ; Vol. 51, No. 3.
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