Online ISSN: 2515-8260

Keywords : Acute respiratory distress syndrome (ARDS)

A Hospital Based Observational Study to Assess the Clinic-Etiological Profile and Prognostic Indicators in Critically Ill Patients who Develop Acute Respiratory Distress Syndrome (ARDS) in Medical Intensive Care Unit

Suman, V.B. Singh, Deepak Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2255-2260

Background: Aspiration pneumonia and pneumonia are the most common cause of ARDS in direct lung injury whereas sepsis is the most common cause of ARDS in Indirect lung injury. The aim of this study to assess the clinic-etiological profile and prognostic indicators in critically ill patients who develop acute respiratory distress syndrome (ARDS) in medical intensive care unit.
Materials& Methods: A hospital based prospective study done on 50 ARDS patients those were admitted in the medical ICU over a period of one year at SMS Medical College, Jaipur, Rajasthan, India. Baseline characteristics including comorbidities, routine investigations, initial SOFA Scores & APACHE II (Acute Physiology & Chronic Health Evaluation) score was evaluated. Descriptive & Statistical analysis and interpretation of the data collected is done by using SPSS version 22.0 with mean and standard deviations computed.
Results: Among 50 patients, 27 patients represent the male group and 23 patients represent the female group. Diabetes mellitus (36%) and SHT (20%) having a higher prevalence. Breathlessness and fever were the most common symptoms. Gender comparison of mean Fio2/Pao2 ratio, MAP, Initial SOFA and APACHE II scores are shown in table 4 showing a higher Fio2 requirement in female group when compared to the male group and more or less equal with the remaining variables. The mean duration of hospital stay was longer in the female group when compared to the male group (table 4). The mortality rate in our study was 16.0% (8 patients).
Conclusion: The incidence of ARDS studies in India are very few and lacking. Early identification and etiology work up for ARDS with timely administration of antibiotics/ antivirals or antimalarial drugs is necessary for the improvement in survival rates in view of increased morbidity and mortality associated with ARDS.

Prone positioning in the management of spontaneously breathing non intubated covid-19 patients on oxygen therapy: A prospective observational study

Patel Shweta A, Chaudhari Tejalben A

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1458-1464

Background: There are various studies that suggest that short term and early prone positioning can increase PaO2/FiO2 in moderate to severe acute respiratory distress syndrome (ARDS). The aim of our study was to observe the effect of prone position on oxygenation status in spontaneously breathing non intubated covid19 patients on either non rebreathing mask (NRBM) or on noninvasive ventilation (NIV).
Aims: To observe the effect of prone position along with oxygen therapy (NIV or NRBM) on oxygenation in spontaneously breathing none intubated covid19 patient.
Material and Methods: This prospective observational study was performed in a covid19 intensive care unit (ICU) at tertiary care hospital for the period of two months. Non-intubated confirmed RTPCR (Reverse transcription polymerase chain reaction) positive covid19 patients were included and observed who were placed in prone position with NIV BIPAP (Bi level positive airway pressure) or with NRBM by ICU consultant. Primary outcome was oxygenation status from Pao2/fio2 ratio from arterial blood gas analysis. Secondary outcome was hemodynamic parameter and any adverse effect occurred during prone positioning. Collected data were analyzed using SPSS software and P value of Pao2/Fio2 ratio of before and after prone position, less than 0.05 considered significant.
Results: We observed among our study participants significant improvement of PaO2/FiO2 ratio in both group of patients.
Conclusions: Early use of prone position improved oxygenation in majority of our patients in short periods of time in both NIV and NRBM group of patients.