Application of the Berlin definition to postoperative acute respiratory distress syndrome in patients with Stanford Type A aortic dissection
10.3760/cma.j.cn431274-20231127-00605
- VernacularTitle:柏林定义在Stanford A型主动脉夹层患者术后急性呼吸窘迫综合征中的应用
- Author:
Teng CAI
1
;
Ning YANG
;
Dongwen MA
;
Jie WANG
;
Guoqiang CAI
;
Zhonghua FEI
;
Chenghui YANG
Author Information
1. 济宁医学院附属医院心脏重症医学科，济宁 272029
- Publication Type:Journal Article
- Keywords:
Aortic diseases;
Artery dissecting;
Respiratory distress syndrome
- From:
Journal of Chinese Physician
2024;26(12):1773-1777
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To evaluate the clinical outcome of acute respiratory distress syndrome (ARDS) in patients with Stanford Type A aortic dissection (AAD).Methods:A total of 212 patients diagnosed with AAD and receiving surgical treatment in the Affiliated Hospital of Jining Medical University from January 2016 to December 2021 were included. The patients were divided into ARDS group and non-ARDS group based on the definition of ARDS Berlin after surgery. The preoperative general clinical data of the two groups were compared by univariate analysis, and the preference-matching variables were screened. The patients were divided into ARDS group ( n=63) and non-ARDS group ( n=63) by using propensity matching score, and the clinical outcome indexes of ARDS group and non-ARDS group were compared after matching. Results:A total of 63 patients (29.7%) were diagnosed with ARDS after AAD. A total of 63 pairs of patients were successfully matched using propensity score to adjust preoperative confounding factors. After matching, the proportion of total arch surgery, operation time, perioperative blood loss, red blood cell transfusion and plasma transfusion in the ARDS group were significantly higher than those in the non-ARDS group, with statistical significance (all P<0.05). After the match, In the ARDS group, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score [18(14-24)points vs 13(12-15)points], mechanical ventilation time [86.0(57.3-158.0)h vs 41.5(23.8-60.4)h], intensive care unit (ICU) stay time [7.0(6.0-11.5)d vs 4.0(3.0-6.0)d] and hospital stay [18.0(14.0-24.5)d vs 13.5(10.8-18.0)d] were significantly higher than those in the non-ARDS group, with statistical significance (all P<0.05). There was no significant difference in in-hospital mortality (3.2% vs 1.6%) or within 30 days after discharge (6.3% vs 3.2%) between the two groups (all P>0.05). Conclusions:The incidence of ARDS is higher in patients diagnosed with AAD based on the Berlin definition, but there is no increase in the mortality rate within 30 days of hospital and discharge in ARDS group. The Berlin definition of ARDS may have some limitations in the application of ARDS in patients with AAD after surgery.
