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Multiple Organ System Failure and Infection in Adult Respiratory Distress Syndrome
Abstract
Patients with the adult respiratory distress syndrome and multiple organ system failure have a high mortality rate despite extensive supportive therapy. We evaluated the role of multiple organ system failure and infection in 37 consecutive survivors of the syndrome, and 47 consecutive nonsurvivors on whom autopsies were done. Failure of the central nervous, coagulation, endocrine, gastrointestinal, and renal systems was common in all patients but was more frequent in those who died. Major infections occurred in 46 nonsurvivors and 22 survivors. All patients with bacteremia who had a clinically identified site of infection survived, whereas all patients with bacteremia without a clinically identified site of infection died. Autopsy results of the latter group showed infections requiring surgical drainage for complete therapy. Patients clinically septic but without bacteremia and without a clear site of infection were shown at autopsy to have pneumonia. Multiple organ system failure was more common in infected (93%) than noninfected (47%) patients. Vigorous evaluation and treatment of infection in patients with the adult respiratory distress syndrome may improve survival.
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Bernard, G. R., Artigas, A., Brigham, K. L., Carlet, J., Falke, K., Hudson, L., Lamy, M., Legall, J. R., Morris, A., & Spragg, R. (1994) · American journal of respiratory and critical care medicine · doi:10.1164/ajrccm.149.3.7509706 · Cited by 6,746
The Acute Respiratory Distress Syndrome
Ware, L. B., & Matthay, M. A. (2000) · New England Journal of Medicine · doi:10.1056/nejm200005043421806 · Cited by 4,666
Colletti, L. M., Remick, D. G., Burtch, G. D., Kunkel, S. L., Strieter, R. M., & Campbell, D. A. (1990) · Journal of Clinical Investigation · doi:10.1172/jci114656 · Cited by 817
Two-Year Cognitive, Emotional, and Quality-of-Life Outcomes in Acute Respiratory Distress Syndrome
Hopkins, R. O., Weaver, L. K., Collingridge, D., Parkinson, R. B., Chan, K. J., & Orme, J. F. (2005) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200406-763oc · Cited by 759
Postinjury Multiple Organ Failure: A Bimodal Phenomenon
Moore, F. A., Sauaia, A., Moore, E. E., Haenel, J. B., Burch, J. M., & Lezotte, D. C. (1996) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/00005373-199604000-00001 · Cited by 491
Kacmarek, R. M., Villar, J., Sulemanji, D., Montiel, R., Ferrando, C., Blanco, J., Koh, Y., Soler, J. A., Martínez, D., Hernández, M., et al. (2016) · Critical Care Medicine · doi:10.1097/ccm.0000000000001383 · Cited by 288
Nosocomial pneumonia in patients with acute respiratory distress syndrome
CHASTRE, J., TROUILLET, J. L., VUAGNAT, A., JOLY-GUILLOU, M. L., CLAVIER, H., DOMBRET, M. C., & GIBERT, C. (1998) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.157.4.9708057 · Cited by 250
Gram-Negative Sepsis and the Adult Respiratory Distress Syndrome
Martin, M. A., & Silverman, H. J. (1992) · Clinical Infectious Diseases · doi:10.1093/clinids/14.6.1213 · Cited by 109
Azghani, A. O., Gray, L. D., & Johnson, A. R. (1993) · Infection and Immunity · doi:10.1128/iai.61.6.2681-2686.1993 · Cited by 73
Metadata
- Authors
- BELL, R. C., COALSON, J. J., SMITH, J. D., & JOHANSON, W. G.
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 1983-09-01
- Volume
- 99
- Issue
- 3
- Pages
- 293-298
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2003673873
- Cited by
- 646
- References
- 0
- FWCI
- 26.53
- Type
- journal article
- Language
- en
- Open access
- closed
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