Acute Lung Injury ; epidemiology ; etiology ; therapy ; Humans ; Respiratory Distress Syndrome, Adult ; epidemiology ; etiology ; therapy

PURPOSE: In recent years, a variety of acute respiratory distress syndrome (ARDS) evaluation systems have been developed worldwide; however, they are not so convenient for the doctors clinically, we decided to establish and evaluate a simplified evaluation system of ARDS (SESARDS). MATERIALS AND METHODS: Data from 140 ARDS patients (derivation data set) were collected to screen for prognostic factors affecting outcomes in ARDS patients. By logistic regression analysis, scores were allocated to corresponding intervals of the variables, respectively, by means of analysis of the frequency distribution to establish a preliminary scoring system. Based on this primary scoring system, a definitive evaluation scheme was created through consultation with a panel of experts. The scores for the validation data set (92 cases) were assigned and calculated by their predictive mortality with the SESARDS and acute physiology and chronic health evaluation II (APACHE II). The performance of SESARDS was compared with that of APACHE II by means of statistical analysis. RESULTS: The factors of age, pH, Glasgow coma scale (GCS), oxygenation index (OI), and the lobes of lung were associated with prognosis of ARDS respectively. The sensitivity and specificity of SESARDS for the validation data set were 96.43% and 58.33%, respectively. On the AUC, no significant difference between APACHE II and SESARDS was detected. There were no significant differences between the prediction and the actuality obtained by SESARDS for the validation data set the SESARDS scores were positively correlated with the actual mortality. CONCLUSION: SESARDS was shown to be simple, accurate and effective in predicting ARDS progression.
APACHE ; Adult ; Age Factors ; Aged ; Female ; Glasgow Coma Scale ; Humans ; Logistic Models ; Male ; Middle Aged ; Probability ; Reproducibility of Results ; Republic of Korea/epidemiology ; Respiratory Distress Syndrome, Adult/diagnosis/*etiology/*mortality

When treating trauma patients with severe hemorrhage, massive transfusions are often needed. Damage control resuscitation strategies can be used for such patients, but an adequate fresh frozen plasma: packed red blood cell (FFP:PRBC) administration ratio must be established. We retrospectively reviewed the medical records of 100 trauma patients treated with massive transfusions from March 2010 to October 2012. We divided the patients into 2 groups according to the FFP:PRBC ratio: a high-ratio (> or =0.5) and a low-ratio group (<0.5). The patient demographics, fluid and transfusion quantities, laboratory values, complications, and outcomes were analyzed and compared. There were 68 patients in the high-ratio and 32 in the low-ratio group. There were statistically significant differences between groups in the quantities of FFP, FFP:PRBC, platelets, and crystalloids administered, as well as the initial diastolic blood pressure. Bloodstream infections were noted only in the high-ratio group, and the difference was statistically significant (P=0.028). Kaplan-Meier plots revealed that the 24-hr survival rate was significantly higher in the high-ratio group (71.9% vs. 97.1%, P<0.001). In severe hemorrhagic trauma, raising the FFP:PRBC ratio to 0.5 or higher may increase the chances of survival. Efforts to minimize bloodstream infections during the resuscitation must be increased.
Acute Lung Injury/epidemiology/etiology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacterial Infections/epidemiology ; *Blood Transfusion/adverse effects ; *Erythrocyte Transfusion/adverse effects ; Female ; Hemorrhage/etiology/*prevention & control ; Hospital Mortality ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Patients ; Respiratory Distress Syndrome, Adult/epidemiology/etiology ; Resuscitation ; Retrospective Studies ; Wounds and Injuries/complications/mortality/*therapy ; Young Adult

OBJECTIVETo study the epidemiology of Acinetobacter baumannii infection in patients with ventilator-associated pneumonia (VAP).

METHODSProspective clinical study was carried out with 176 episodes of VAP with etiologic diagnosis being followed in two groups.

RESULTSTwenty-six episodes were caused by Acinetobacter baumannii and one hundred-fifty episodes were caused by "other" organisms. Using logistic regression analysis, the risk of VAP due to Acinetobacter baumannii was found to be high in patients with head trauma [odds ratio (OR) = 4.20, 95% confidence interva (CI): 2.72 to 6.48], surgery (OR = 2.88, 95% CI: 1.78 to 4.66), acute respiratory dispnea syndrome (OR = 2.81, 95% CI: 1.19 to 6.64), and large-volume pulmonary aspiration (OR = 6.71, 95% CI: 3.91 to 11.50).

CONCLUSIONSAcinetobacter baumannii pulmonary infection in incubated patients had an epidemiological pattern that different from "other" organisms. Patients with high risk identified in our study might mark the existence of cross-infection during airway manipulation.

Acinetobacter ; classification ; isolation & purification ; Acinetobacter Infections ; epidemiology ; etiology ; Aged ; Aged, 80 and over ; China ; epidemiology ; Cross Infection ; epidemiology ; etiology ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Male ; Middle Aged ; Pneumonia, Bacterial ; etiology ; microbiology ; Prospective Studies ; Respiration, Artificial ; adverse effects ; Respiratory Distress Syndrome, Adult ; complications ; Risk Factors ; Time Factors ; Ventilators, Mechanical ; adverse effects