Clinical profiles and prognostic risk factors in ALI/ARDS patients after non-cardiac operations in SICU

Objective To retrospectively investigate the clinical characters of acute lung injury / acute respiratory distress syndrome (ALI/ARDS) patients in surgical intensive care unit (SICU) after non cardiac operations in order to clarify the incidences and related prognostic risk factors. Methods The clinical data of 105 patients after non-cardiac operations who were admitted to SICU from September 2006 to August 2007 were reviewed. The patients were divided into three groups according to the guideline of ALI/ARDS revised by the Chinese Society of Critical Care Medicine (CCCM,2006):PaCO2/FiO2 index normal group,ALI group and ARDS group. Patients' age,weight,body mass index (BMI),time of staying in SICU,mortality in SICU and 30 days after discharged from SICU,bleeding in operation,total intravenous fluid administration in operation were compared among different groups. The logistic regression analysis was performed to indentify the factors influencing the prognosis of ALI/ARDS patients.Results The age,weight and BMI of patients were significantly different among the groups. Patients in ARDS group were heavier and had higher BMI than those in other groups; the time of staying in SICU was significantly prolonged. There were no significant differences in the mortality among three groups. Patients with ARDS or ALI were mostly from abdomen surgery department (including liver transplantation and gastroenteritic surgery). The age was the independent factor that could influence the prognosis of ALI/ARDS patients. The elder patients had higher mortality than younger patients. Conclusion The elder or heavier patients were more susceptible to develop ALI/ARDS. Management of such high-risk patients during peri-operaional period should be strengthened in order to decrease the morbidity of AL1/ARDS and mortality after operation.