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Risk Factors of Mikkelsen et al for the Acute Respiratory Distress Syndrome (ARDS) in a Patient with Severe Sepsis in the Emergency Department

Description

Mikkelsen et al identifie risk factors for the development of acute respiratory distress syndrome (ARDS) in patients with severe sepsis in the Emergency Department. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Pennsylvania, Morristown Medical Center, Columbia University Medical Center and Georgetown University.


Patient selection: severe sepsis in the Emergency Department

 

Outcome: ARDS

 

Risk factors for the development of ARDS:

(1) serum lactate concentration >= 2.0 mmol/L

(2) lung injury prediction score of Gajic et al (LIPS, adjusted odds ratio 1.37 per unit increase).

(3) microbiologically-proven infection (adjusted odds ratio 2.6)

 

Serum Lactate

Group (Odds Ratio)

Incidence ARDS

< 2 mmol/L

low (OR 1)

1.6%

2.0 to 3.9 mmol/L

intermediate (OR 3.9)

4.8%

>= 4.0 mmol/L

high (OR 5.6)

12%

 

The risk of ARDS increased with rising serum lactate concentration.


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