Monday July 14, 2008
ARDS is ARDS !!

No! its no different or easy even if ARDS occurs due to extrapulmonary causes. See this study recently published in Chest 1.

Background: ARDS can occur from the two pathogenetic pathways: a direct pulmonary injury (ARDSp); and an indirect injury (ARDSexp).The metaanalysis was aimed at evaluating whether there is any difference in mortality between the two groups.

Methods: MEDLINE, EMBASE, and CINAHL databases were searched for relevant studies published from 1987 to 2007, and included studies that have reported mortality in the two groups of ARDS.

Results: 34 studies were find. In all, the studies involved 4,311 patients with

• 2,330 patients in the ARDSp group and
• 1,981 patients in the ARDSexp group

1. Mortality was similar in the two groups.
2. The mortality was no different whether the studies were classified as prospective or retrospective; small or large; or observational or interventional

Conclusions: The results of this study suggest that there is no difference in mortality between these two groups. Further studies should focus on specific etiologies within the subgroups rather than focusing on the broader division of ARDSp and ARDSexp.




Reference: click to get abstract

Is the Mortality Higher in the Pulmonary vs the Extrapulmonary ARDS?: A Metaanalysis Agarwal et al. Chest. 2008; 133: 1463-1473