- 1. Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
- 2. Department of Critical Care Medicine, the Public Health Clinical Medical Center of Chengdu, Chengdu, Sichuan 610066, P .R. China;
Acute respiratory distress syndrome is caused by all kinds of damage factors of acute diffuse inflammatory lung injury, with respiratory distress and difficult to correct hypoxemia as the main performance of clinical syndrome, its pathogenesis is complex, pathological physiology change exists heterogeneity, and the case fatality rate is high, seriously endanger the patient’s life and health. By reviewing the relevant studies at home and abroad in recent years, this article reviews the research progress of risk factors, diagnosis and treatment of acute respiratory distress syndrome, in order to provide a basis and reference for clinical diagnosis and treatment and future exploration.
Citation: ZHANG Lihui, CHEN Xuerong. Prediction of risk factors and progress in diagnosis and treatment of acute respiratory distress syndrome. West China Medical Journal, 2023, 38(1): 103-110. doi: 10.7507/1002-0179.202210208 Copy
1. | ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA, 2012, 307(23): 2526-2533. |
2. | Bellani G, Laffey JG, Pham T, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA, 2016, 315(8): 788-800. |
3. | 贾子毅, 刘晓伟, 刘志. 机械通气氧合指数对 ARDS 患者预后评估的价值: 附 228 例回顾性分析. 中华危重病急救医学, 2017, 29(1): 45-50. |
4. | Hasan SS, Capstick T, Ahmed R, et al. Mortality in COVID-19 patients with acute respiratory distress syndrome and corticosteroids use: a systematic review and meta-analysis. Expert Rev Respir Med, 2020, 14(11): 1149-1163. |
5. | Wu C, Chen X, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med, 2020, 180(7): 934-943. |
6. | Xu W, Sun NN, Gao HN, et al. Risk factors analysis of COVID-19 patients with ARDS and prediction based on machine learning. Sci Rep, 2021, 11(1): 2933. |
7. | Wang A, Gao G, Wang S, et al. Clinical characteristics and risk factors of acute respiratory distress syndrome (ARDS) in COVID-19 patients in Beijing, China: a retrospective study. Med Sci Monit, 2020, 26: e925974. |
8. | Reynolds D, Kashyap R, Wallace L, et al. Older adult patients are at lower risk of ARDS compared to younger patients at risk: secondary analysis of a multicenter cohort study. J Intensive Care Med, 2020, 35(1): 42-47. |
9. | Daher P, Teixeira PG, Coopwood TB, et al. Mild to moderate to severe: what drives the severity of ARDS in trauma patients?. Am Surg, 2018, 84(6): 808-812. |
10. | Howells PA, Aldridge KA, Parekh D, et al. ARDS following oesophagectomy: a comparison of two trials. BMJ Open Respir Res, 2017, 4(1): e000207. |
11. | Afshar M, Netzer G, Mosier MJ, et al. The contributing risk of tobacco use for ARDS development in burn-injured adults with inhalation injury. Respir Care, 2017, 62(11): 1456-1465. |
12. | Rhee J, Dominici F, Zanobetti A, et al. Impact of long-term exposures to ambient PM2.5 and ozone on ARDS risk for older adults in the United States. Chest, 2019, 156(1): 71-79. |
13. | Eworuke E, Major JM, Gilbert McClain LI. National incidence rates for acute respiratory distress syndrome (ARDS) and ARDS cause-specific factors in the United States (2006-2014). J Crit Care, 2018, 47: 192-197. |
14. | Bhadade R, de’Souza R, Harde M, et al. Mortality predictors of ARDS in medical intensive care unit of a tertiary care centre in a tropical country. J Assoc Physicians India, 2015, 63(11): 16-22. |
15. | Daurat A, Millet I, Roustan JP, et al. Thoracic Trauma Severity score on admission allows to determine the risk of delayed ARDS in trauma patients with pulmonary contusion. Injury, 2016, 47(1): 147-153. |
16. | Xu Z, Wu GM, Li Q, et al. Predictive value of combined LIPS and ANG-2 level in critically ill Patients with ARDS risk factors. Mediators Inflamm, 2018, 2018: 1739615. |
17. | Rahmel T, Nowak H, Rump K, et al. The aquaporin 5 -1364A/C promoter polymorphism impacts on resolution of acute kidney injury in pneumonia evoked ARDS. PLoS One, 2018, 13(12): e0208582. |
18. | Xu F, Yuan J, Tian S, et al. MicroRNA-92a serves as a risk factor in sepsis-induced ARDS and regulates apoptosis and cell migration in lipopolysaccharide-induced HPMEC and A549 cell injury. Life Sci, 2020, 256: 117957. |
19. | Ding Y, Feng Q, Chen J, et al. TLR4/NF-κB signaling pathway gene single nucleotide polymorphisms alter gene expression levels and affect ARDS occurrence and prognosis outcomes. Medicine (Baltimore), 2019, 98(26): e16029. |
20. | Serpa Neto A, Juffermans NP, Hemmes SNT, et al. Interaction between peri-operative blood transfusion, tidal volume, airway pressure and postoperative ARDS: an individual patient data meta-analysis. Ann Transl Med, 2018, 6(2): 23. |
21. | Bernard GR, Artigas A, Brigham K, et al. The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med, 1994, 149(3 Pt 1): 818-824. |
22. | Scala R. Non-invasive positive pressure mechanical ventilation in acute respiratory failure. Minerva Anestesiol 2000, 66(10): 697-712. |
23. | Luo J, Wang MY, Zhu H, et al. Can non-invasive positive pressure ventilation prevent endotracheal intubation in acute lung injury/acute respiratory distress syndrome? A meta-analysis. Respirology, 2014, 19(8): 1149-1157. |
24. | Taha A, Larumbe-Zabala E, Abugroun A, et al. Outcomes of noninvasive positive pressure ventilation in acute respiratory distress syndrome and their predictors: a national cohort. Crit Care Res Pract, 2019, 2019: 8106145. |
25. | 杜玲玲, 韩浩, 张晓军, 等. 有创-无创序贯性机械通气治疗老年肺内源性急性呼吸窘迫综合征随机对照临床研究. 中国危重病急救医学, 2009, 21(7): 394-396. |
26. | Mosier JM, Sakles JC, Whitmore SP, et al. Failed noninvasive positive-pressure ventilation is associated with an increased risk of intubation-related complications. Ann Intensive Care, 2015, 5: 4. |
27. | Antonelli M, Conti G, Moro ML, et al. Predictors of failure of noninvasive positive pressure ventilation in patients with acute hypoxemic respiratory failure: a multi-center study. Intensive Care Med, 2001, 27(11): 1718-1728. |
28. | Abdel Hakim K, Mohamed AI, Chaari A, et al. Successful management of H1N1 related severe acute respiratory distress syndrome with noninvasive positive pressure ventilation. Ann Transl Med, 2016, 4(9): 175. |
29. | Carrasco Loza R, Villamizar Rodríguez G, Medel Fernández N. Ventilator-induced lung injury (VILI) in acute respiratory distress syndrome (ARDS): volutrauma and molecular effects. Open Respir Med J, 2015, 9: 112-119. |
30. | Sutherasan Y, Vargas M, Pelosi P. Protective mechanical ventilation in the non-injured lung: review and meta-analysis. Crit Care, 2014, 18(2): 211. |
31. | Udi J, Lang CN, Zotzmann V, et al. Incidence of barotrauma in patients with COVID-19 pneumonia during prolonged invasive mechanical ventilation - a case-control study. J Intensive Care Med, 2021, 36(4): 477-483. |
32. | Coppola S, Froio S, Chiumello D. Higher vs. lower PEEP in ARDS:just one part of the whole. J Thorac Dis, 2018, 10(1): 56-59. |
33. | Bein T, Weber-Carstens S, Apfelbacher C, et al. The quality of acute intensive care and the incidence of critical events have an impact on health-related quality of life in survivors of the acute respiratory distress syndrome - a nationwide prospective multicenter observational study. Ger Med Sci, 2020, 18: Doc01. |
34. | 杨全会, 刘大为, 王海军, 等. 小潮气量结合肺复张术对食管癌开胸术后早期急性呼吸窘迫综合征患者的疗效. 中华外科杂志, 2010, 48(19): 1484-1487. |
35. | Fernando SM, Fan E, Rochwerg B, et al. Lung-protective ventilation and associated outcomes and costs among patients receiving invasive mechanical ventilation in the ED. Chest, 2021, 159(2): 606-618. |
36. | Richard JC, Marque S, Gros A, et al. Feasibility and safety of ultra-low tidal volume ventilation without extracorporeal circulation in moderately severe and severe ARDS patients. Intensive Care Med, 2019, 45(11): 1590-1598. |
37. | Duan M, Berra L, Kumar A, et al. Use of hypothermia to allow low-tidal-volume ventilation in a patient with ARDS. Respir Care, 2011, 56(12): 1956-1958. |
38. | Sahetya SK, Brower RG. Lung recruitment and titrated PEEP in moderate to severe ARDS: is the door closing on the open lung?. JAMA, 2017, 318(14): 1327-1329. |
39. | Kallet RH. Should PEEP titration be based on chest mechanics in patients with ARDS?. Respir Care, 2016, 61(6): 876-890. |
40. | Guo L, Xie J, Huang Y, et al. Higher PEEP improves outcomes in ARDS patients with clinically objective positive oxygenation response to PEEP: a systematic review and meta-analysis. BMC Anesthesiol, 2018, 18(1): 172. |
41. | Kasenda B, Sauerbrei W, Royston P, et al. Multivariable fractional polynomial interaction to investigate continuous effect modifiers in a meta-analysis on higher versus lower PEEP for patients with ARDS. BMJ Open, 2016, 6(9): e011148. |
42. | Sang L, Zheng X, Zhao Z, et al. Lung recruitment, individualized peep, and prone position ventilation for COVID-19-associated severe ARDS: a single center observational study. Front Med (Lausanne), 2020, 7: 603943. |
43. | Hochhausen N, Biener I, Rossaint R, et al. Optimizing PEEP by electrical impedance tomography in a porcine animal model of ARDS. Respir Care, 2017, 62(3): 340-349. |
44. | Casserly B, McCool FD, Saunders J, et al. End-expiratory volume and oxygenation: targeting PEEP in ARDS patients. Lung, 2016, 194(1): 35-41. |
45. | Chung FT, Lee CS, Lin SM, et al. Alveolar recruitment maneuver attenuates extravascular lung water in acute respiratory distress syndrome. Medicine (Baltimore), 2017, 96(30): e7627. |
46. | 李孝建, 钟晓旻, 邓忠远, 等. 肺保护性通气策略联合肺复张对严重烧伤并发急性呼吸窘迫综合征患者的疗效. 中华烧伤杂志, 2014, 30(4): 305-309. |
47. | Liu X, Ma T, Qu B, et al. Efficacy of lung recruitment maneuver with high-level positive end-expiratory pressure in patients with influenza-associated acute respiratory distress: a single-center prospective study. Curr Ther Res Clin Exp, 2013, 75: 83-87. |
48. | Pensier J, de Jong A, Hajjej Z, et al. Effect of lung recruitment maneuver on oxygenation, physiological parameters and mortality in acute respiratory distress syndrome patients: a systematic review and meta-analysis. Intensive Care Med, 2019, 45(12): 1691-1702. |
49. | Iannuzzi M, De Sio A, De Robertis E, et al. Different patterns of lung recruitment maneuvers in primary acute respiratory distress syndrome: effects on oxygenation and central hemodynamics. Minerva Anestesiol, 2010, 76(9): 692-698. |
50. | Ayala C, Baiu I, Owyang C, et al. Rhinovirus-associated severe acute respiratory distress syndrome (ARDS) managed with airway pressure release ventilation (APRV). Trauma Surg Acute Care Open, 2019, 4(1): e000322. |
51. | Roy S, Habashi N, Sadowitz B, et al. Early airway pressure release ventilation prevents ARDS-a novel preventive approach to lung injury. Shock, 2013, 39(1): 28-38. |
52. | Mireles-Cabodevila E, Kacmarek RM. Should airway pressure release ventilation be the primary mode in ARDS?. Respir Care, 2016, 61(6): 761-773. |
53. | Sud S, Sud M, Friedrich JO, et al. High frequency oscillation in patients with acute lung injury and acute respiratory distress syndrome (ARDS): systematic review and meta-analysis. BMJ, 2010, 340: c2327. |
54. | Ferguson ND, Cook DJ, Guyatt GH, et al. High-frequency oscillation in early acute respiratory distress syndrome. N Engl J Med, 2013, 368(9): 795-805. |
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- 1. ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA, 2012, 307(23): 2526-2533.
- 2. Bellani G, Laffey JG, Pham T, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA, 2016, 315(8): 788-800.
- 3. 贾子毅, 刘晓伟, 刘志. 机械通气氧合指数对 ARDS 患者预后评估的价值: 附 228 例回顾性分析. 中华危重病急救医学, 2017, 29(1): 45-50.
- 4. Hasan SS, Capstick T, Ahmed R, et al. Mortality in COVID-19 patients with acute respiratory distress syndrome and corticosteroids use: a systematic review and meta-analysis. Expert Rev Respir Med, 2020, 14(11): 1149-1163.
- 5. Wu C, Chen X, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med, 2020, 180(7): 934-943.
- 6. Xu W, Sun NN, Gao HN, et al. Risk factors analysis of COVID-19 patients with ARDS and prediction based on machine learning. Sci Rep, 2021, 11(1): 2933.
- 7. Wang A, Gao G, Wang S, et al. Clinical characteristics and risk factors of acute respiratory distress syndrome (ARDS) in COVID-19 patients in Beijing, China: a retrospective study. Med Sci Monit, 2020, 26: e925974.
- 8. Reynolds D, Kashyap R, Wallace L, et al. Older adult patients are at lower risk of ARDS compared to younger patients at risk: secondary analysis of a multicenter cohort study. J Intensive Care Med, 2020, 35(1): 42-47.
- 9. Daher P, Teixeira PG, Coopwood TB, et al. Mild to moderate to severe: what drives the severity of ARDS in trauma patients?. Am Surg, 2018, 84(6): 808-812.
- 10. Howells PA, Aldridge KA, Parekh D, et al. ARDS following oesophagectomy: a comparison of two trials. BMJ Open Respir Res, 2017, 4(1): e000207.
- 11. Afshar M, Netzer G, Mosier MJ, et al. The contributing risk of tobacco use for ARDS development in burn-injured adults with inhalation injury. Respir Care, 2017, 62(11): 1456-1465.
- 12. Rhee J, Dominici F, Zanobetti A, et al. Impact of long-term exposures to ambient PM2.5 and ozone on ARDS risk for older adults in the United States. Chest, 2019, 156(1): 71-79.
- 13. Eworuke E, Major JM, Gilbert McClain LI. National incidence rates for acute respiratory distress syndrome (ARDS) and ARDS cause-specific factors in the United States (2006-2014). J Crit Care, 2018, 47: 192-197.
- 14. Bhadade R, de’Souza R, Harde M, et al. Mortality predictors of ARDS in medical intensive care unit of a tertiary care centre in a tropical country. J Assoc Physicians India, 2015, 63(11): 16-22.
- 15. Daurat A, Millet I, Roustan JP, et al. Thoracic Trauma Severity score on admission allows to determine the risk of delayed ARDS in trauma patients with pulmonary contusion. Injury, 2016, 47(1): 147-153.
- 16. Xu Z, Wu GM, Li Q, et al. Predictive value of combined LIPS and ANG-2 level in critically ill Patients with ARDS risk factors. Mediators Inflamm, 2018, 2018: 1739615.
- 17. Rahmel T, Nowak H, Rump K, et al. The aquaporin 5 -1364A/C promoter polymorphism impacts on resolution of acute kidney injury in pneumonia evoked ARDS. PLoS One, 2018, 13(12): e0208582.
- 18. Xu F, Yuan J, Tian S, et al. MicroRNA-92a serves as a risk factor in sepsis-induced ARDS and regulates apoptosis and cell migration in lipopolysaccharide-induced HPMEC and A549 cell injury. Life Sci, 2020, 256: 117957.
- 19. Ding Y, Feng Q, Chen J, et al. TLR4/NF-κB signaling pathway gene single nucleotide polymorphisms alter gene expression levels and affect ARDS occurrence and prognosis outcomes. Medicine (Baltimore), 2019, 98(26): e16029.
- 20. Serpa Neto A, Juffermans NP, Hemmes SNT, et al. Interaction between peri-operative blood transfusion, tidal volume, airway pressure and postoperative ARDS: an individual patient data meta-analysis. Ann Transl Med, 2018, 6(2): 23.
- 21. Bernard GR, Artigas A, Brigham K, et al. The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med, 1994, 149(3 Pt 1): 818-824.
- 22. Scala R. Non-invasive positive pressure mechanical ventilation in acute respiratory failure. Minerva Anestesiol 2000, 66(10): 697-712.
- 23. Luo J, Wang MY, Zhu H, et al. Can non-invasive positive pressure ventilation prevent endotracheal intubation in acute lung injury/acute respiratory distress syndrome? A meta-analysis. Respirology, 2014, 19(8): 1149-1157.
- 24. Taha A, Larumbe-Zabala E, Abugroun A, et al. Outcomes of noninvasive positive pressure ventilation in acute respiratory distress syndrome and their predictors: a national cohort. Crit Care Res Pract, 2019, 2019: 8106145.
- 25. 杜玲玲, 韩浩, 张晓军, 等. 有创-无创序贯性机械通气治疗老年肺内源性急性呼吸窘迫综合征随机对照临床研究. 中国危重病急救医学, 2009, 21(7): 394-396.
- 26. Mosier JM, Sakles JC, Whitmore SP, et al. Failed noninvasive positive-pressure ventilation is associated with an increased risk of intubation-related complications. Ann Intensive Care, 2015, 5: 4.
- 27. Antonelli M, Conti G, Moro ML, et al. Predictors of failure of noninvasive positive pressure ventilation in patients with acute hypoxemic respiratory failure: a multi-center study. Intensive Care Med, 2001, 27(11): 1718-1728.
- 28. Abdel Hakim K, Mohamed AI, Chaari A, et al. Successful management of H1N1 related severe acute respiratory distress syndrome with noninvasive positive pressure ventilation. Ann Transl Med, 2016, 4(9): 175.
- 29. Carrasco Loza R, Villamizar Rodríguez G, Medel Fernández N. Ventilator-induced lung injury (VILI) in acute respiratory distress syndrome (ARDS): volutrauma and molecular effects. Open Respir Med J, 2015, 9: 112-119.
- 30. Sutherasan Y, Vargas M, Pelosi P. Protective mechanical ventilation in the non-injured lung: review and meta-analysis. Crit Care, 2014, 18(2): 211.
- 31. Udi J, Lang CN, Zotzmann V, et al. Incidence of barotrauma in patients with COVID-19 pneumonia during prolonged invasive mechanical ventilation - a case-control study. J Intensive Care Med, 2021, 36(4): 477-483.
- 32. Coppola S, Froio S, Chiumello D. Higher vs. lower PEEP in ARDS:just one part of the whole. J Thorac Dis, 2018, 10(1): 56-59.
- 33. Bein T, Weber-Carstens S, Apfelbacher C, et al. The quality of acute intensive care and the incidence of critical events have an impact on health-related quality of life in survivors of the acute respiratory distress syndrome - a nationwide prospective multicenter observational study. Ger Med Sci, 2020, 18: Doc01.
- 34. 杨全会, 刘大为, 王海军, 等. 小潮气量结合肺复张术对食管癌开胸术后早期急性呼吸窘迫综合征患者的疗效. 中华外科杂志, 2010, 48(19): 1484-1487.
- 35. Fernando SM, Fan E, Rochwerg B, et al. Lung-protective ventilation and associated outcomes and costs among patients receiving invasive mechanical ventilation in the ED. Chest, 2021, 159(2): 606-618.
- 36. Richard JC, Marque S, Gros A, et al. Feasibility and safety of ultra-low tidal volume ventilation without extracorporeal circulation in moderately severe and severe ARDS patients. Intensive Care Med, 2019, 45(11): 1590-1598.
- 37. Duan M, Berra L, Kumar A, et al. Use of hypothermia to allow low-tidal-volume ventilation in a patient with ARDS. Respir Care, 2011, 56(12): 1956-1958.
- 38. Sahetya SK, Brower RG. Lung recruitment and titrated PEEP in moderate to severe ARDS: is the door closing on the open lung?. JAMA, 2017, 318(14): 1327-1329.
- 39. Kallet RH. Should PEEP titration be based on chest mechanics in patients with ARDS?. Respir Care, 2016, 61(6): 876-890.
- 40. Guo L, Xie J, Huang Y, et al. Higher PEEP improves outcomes in ARDS patients with clinically objective positive oxygenation response to PEEP: a systematic review and meta-analysis. BMC Anesthesiol, 2018, 18(1): 172.
- 41. Kasenda B, Sauerbrei W, Royston P, et al. Multivariable fractional polynomial interaction to investigate continuous effect modifiers in a meta-analysis on higher versus lower PEEP for patients with ARDS. BMJ Open, 2016, 6(9): e011148.
- 42. Sang L, Zheng X, Zhao Z, et al. Lung recruitment, individualized peep, and prone position ventilation for COVID-19-associated severe ARDS: a single center observational study. Front Med (Lausanne), 2020, 7: 603943.
- 43. Hochhausen N, Biener I, Rossaint R, et al. Optimizing PEEP by electrical impedance tomography in a porcine animal model of ARDS. Respir Care, 2017, 62(3): 340-349.
- 44. Casserly B, McCool FD, Saunders J, et al. End-expiratory volume and oxygenation: targeting PEEP in ARDS patients. Lung, 2016, 194(1): 35-41.
- 45. Chung FT, Lee CS, Lin SM, et al. Alveolar recruitment maneuver attenuates extravascular lung water in acute respiratory distress syndrome. Medicine (Baltimore), 2017, 96(30): e7627.
- 46. 李孝建, 钟晓旻, 邓忠远, 等. 肺保护性通气策略联合肺复张对严重烧伤并发急性呼吸窘迫综合征患者的疗效. 中华烧伤杂志, 2014, 30(4): 305-309.
- 47. Liu X, Ma T, Qu B, et al. Efficacy of lung recruitment maneuver with high-level positive end-expiratory pressure in patients with influenza-associated acute respiratory distress: a single-center prospective study. Curr Ther Res Clin Exp, 2013, 75: 83-87.
- 48. Pensier J, de Jong A, Hajjej Z, et al. Effect of lung recruitment maneuver on oxygenation, physiological parameters and mortality in acute respiratory distress syndrome patients: a systematic review and meta-analysis. Intensive Care Med, 2019, 45(12): 1691-1702.
- 49. Iannuzzi M, De Sio A, De Robertis E, et al. Different patterns of lung recruitment maneuvers in primary acute respiratory distress syndrome: effects on oxygenation and central hemodynamics. Minerva Anestesiol, 2010, 76(9): 692-698.
- 50. Ayala C, Baiu I, Owyang C, et al. Rhinovirus-associated severe acute respiratory distress syndrome (ARDS) managed with airway pressure release ventilation (APRV). Trauma Surg Acute Care Open, 2019, 4(1): e000322.
- 51. Roy S, Habashi N, Sadowitz B, et al. Early airway pressure release ventilation prevents ARDS-a novel preventive approach to lung injury. Shock, 2013, 39(1): 28-38.
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