Analysis of clinical characteristics of patients with acute diffuse lung changes and respiratory failure_West China Medical Journal

Authors：

LIU Chun ¹ ,  ZHENG Xiangde ¹ , LIU Jinping ² , LI Changlong ¹ , LI Wenbin ¹ , WU Changhui ¹

1. Department of Critical Care Medicine, Dazhou Central Hospital, Dazhou, Sichuan 635000, P. R. China;
2. Dazhou Vocational College of Traditional Chinese Medicine, Dazhou, Sichuan 635000, P. R. China;

Corresponding author：

ZHENG Xiangde, Email: 109284521@qq.com

Keywords：

Acute diffuse lung changes; Acute respiratory distress syndrome; Disease characteristics

DOI：

10.7507/1002-0179.201911189

Video：

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Objective To summarize and analyze the clinical characteristics of patients with acute diffuse lung changes and respiratory failure.Methods The clinical data of patients in the Department of Critical Care Medicine, Dazhou Central Hospital between January 2016 and December 2018 were retrospectively collected, whose main clinical manifestation was acute respiratory distress syndrome with acute onset (<3 weeks) and main imaging manifestation was diffuse changes in both lungs. The clinical characteristics of patients were summarized, and the causes of the disease were explored.Results A total of 65 patients with acute diffuse lung changes and respiratory failure were enrolled, including 42 males (64.6%) and 23 females (35.4%). The average age was (57.1±18.4) years, the average time from onset to treatment was (7.5±5.9) d, and the average length of stay in the intensive care unit was (8.9±4.1) d. A total of 23 cases died, with a case-fatality rate of 35.4%. Among the 65 patients, there were 50 case (76.9%) of infectious diseases, including 36 cases of bacterial infections (including 4 cases of tuberculosis), 8 cases of viral infections (all were H1N1 infections), and 6 cases of fungal infections (including 1 case of pneumocystis infection); and there were 15 cases (23.1%) of non-infectious diseases, including 4 cases of acute left heart failure, 2 cases of interstitial pneumonia, 2 cases of vasculitis, 1 case of myositis dermatomyositis, 1 case of aspiration pneumonia, 1 case of acute pulmonary embolism, 1 case of acute drug lung injury, 1 case of neurogenic pulmonary edema, 1 case of drowning, and 1 case of unknown origin.Conclusions Infectious diseases are the main cause of acute diffuse lung changes and respiratory failure, while among non-infectious diseases, acute heart failure and immune system diseases are common causes.

Citation： LIU Chun, ZHENG Xiangde, LIU Jinping, LI Changlong, LI Wenbin, WU Changhui. Analysis of clinical characteristics of patients with acute diffuse lung changes and respiratory failure. West China Medical Journal, 2021, 36(1): 40-44. doi: 10.7507/1002-0179.201911189 Copy

1.	邓彩霞, 汤展宏, 胡军涛. 急性呼吸窘迫综合征预后因素的研究进展. 广西医学, 2018, 40(10): 1216-1218.
2.	Papazian L, Calfee CS, Chiumello D, et al. Diagnostic workup for ARDS patients. Intensive Care Med, 2016, 42(5): 674-685.
3.	ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin definition. JAMA, 2012, 307(23): 2526-2533.
4.	糜丽云, 班承钧, 刘艳, 等. 急性弥漫性肺浸润性改变的临床特征. 中华医学杂志, 2017, 97(44): 3445-3449.
5.	Wong AK, Walkey AJ. Open lung biopsy among critically ill, mechanically ventilated patients. A meta analysis. Ann Am Thorac Soc, 2015, 12(8): 1226-1230.
6.	中华人民共和国卫生部. 甲型H1N1流感诊疗方案(2010 年版). 国际呼吸杂志, 2011, 31(2): 81-84.
7.	Woodhead M, Blasi F, Ewig S, et al. Guidelines for the management of adult lower respiratory tract infections--summary. Clin Microbiol Infect, 2011, 17(Suppl 6): 1-24.
8.	American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med, 2005, 171(4): 388-416.
9.	姚秀娟. 重症弥漫性肺疾病 12 例支气管镜诊断分析. 福建医药杂志, 2016, 38(4): 120-122.
10.	范红, 申永春, 童翔. 社区获得性肺炎病原学变迁. 华西医学, 2018, 33(1): 84-87.
11.	Aliberti S, Messinesi G, Gamberini S, et al. Non-invasive mechanical ventilation in patients with diffuse interstitial lung diseases. BMC Pulm Med, 2014, 14: 194.
12.	李一诗, 郭述良, 易祥华, 等. 经支气管冷冻肺活检对弥漫性肺疾病病因诊断的有效性和安全性. 中华医学杂志, 2017, 97(46): 3617-3623.
13.	吴翔, 方爱珠, 章龙成, 等. 肺泡灌洗液细胞成分分析在弥漫性肺疾病中应用. 临床军医杂志, 2017, 45(8): 857-859.
14.	Gibelin A, Parrot A, Maitre B, et al. Acute respiratory distress syndrome mimickers lacking common risk factors of the Berlin definition. Intensive Care Med, 2016, 42(2): 164-172.
15.	胡译丹, 刘钢, 谢其冰. 特发性炎性肌病相关的间质性肺疾病. 华西医学, 2018, 33(12): 1544-1548.

1. 邓彩霞, 汤展宏, 胡军涛. 急性呼吸窘迫综合征预后因素的研究进展. 广西医学, 2018, 40(10): 1216-1218.
2. Papazian L, Calfee CS, Chiumello D, et al. Diagnostic workup for ARDS patients. Intensive Care Med, 2016, 42(5): 674-685.
3. ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin definition. JAMA, 2012, 307(23): 2526-2533.
4. 糜丽云, 班承钧, 刘艳, 等. 急性弥漫性肺浸润性改变的临床特征. 中华医学杂志, 2017, 97(44): 3445-3449.
5. Wong AK, Walkey AJ. Open lung biopsy among critically ill, mechanically ventilated patients. A meta analysis. Ann Am Thorac Soc, 2015, 12(8): 1226-1230.
6. 中华人民共和国卫生部. 甲型H1N1流感诊疗方案(2010 年版). 国际呼吸杂志, 2011, 31(2): 81-84.
7. Woodhead M, Blasi F, Ewig S, et al. Guidelines for the management of adult lower respiratory tract infections--summary. Clin Microbiol Infect, 2011, 17(Suppl 6): 1-24.
8. American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med, 2005, 171(4): 388-416.
9. 姚秀娟. 重症弥漫性肺疾病 12 例支气管镜诊断分析. 福建医药杂志, 2016, 38(4): 120-122.
10. 范红, 申永春, 童翔. 社区获得性肺炎病原学变迁. 华西医学, 2018, 33(1): 84-87.
11. Aliberti S, Messinesi G, Gamberini S, et al. Non-invasive mechanical ventilation in patients with diffuse interstitial lung diseases. BMC Pulm Med, 2014, 14: 194.
12. 李一诗, 郭述良, 易祥华, 等. 经支气管冷冻肺活检对弥漫性肺疾病病因诊断的有效性和安全性. 中华医学杂志, 2017, 97(46): 3617-3623.
13. 吴翔, 方爱珠, 章龙成, 等. 肺泡灌洗液细胞成分分析在弥漫性肺疾病中应用. 临床军医杂志, 2017, 45(8): 857-859.
14. Gibelin A, Parrot A, Maitre B, et al. Acute respiratory distress syndrome mimickers lacking common risk factors of the Berlin definition. Intensive Care Med, 2016, 42(2): 164-172.
15. 胡译丹, 刘钢, 谢其冰. 特发性炎性肌病相关的间质性肺疾病. 华西医学, 2018, 33(12): 1544-1548.

West China Medical Journal

Analysis of clinical characteristics of patients with acute diffuse lung changes and respiratory failure

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