scholarly journals Prognostic Value of the Red Cell Distribution Width in Patients with Sepsis-Induced Acute Respiratory Distress Syndrome: A Retrospective Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Huabin Wang ◽  
Junbin Huang ◽  
Wenhua Liao ◽  
Jiannan Xu ◽  
Zhongyuan He ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Cohort Study ◽  
Respiratory Distress Syndrome ◽  
Retrospective Cohort ◽  
Prognostic Value ◽  
Distress Syndrome ◽  
Cox Regression ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width

Objective. The prognostic value of the red cell distribution width (RDW) in patients with sepsis-induced acute respiratory distress syndrome (ARDS) is still elusive. This study is aimed at determining whether RDW is a prognostic indicator of sepsis-induced ARDS. Methods. This retrospective cohort study included 1161 patients with sepsis-induced ARDS. The datasets were acquired from the Medical Information Mart for Intensive Care III database. The locally weighted scatter-plot smoothing technique, Cox regression, Kaplan-Meier estimator, and subgroup analysis were carried out to evaluate the association between RDW and 90-day mortality. Results. The RDW and mortality had a roughly linear increasing relationship. The Cox regression model results were as follows: for level 2 ( 14.5 % < RDW < 16.2 % ), hazard ratio   HR = 1.35 , 95% confidence interval   CI = 1.03 – 1.77 , and for level 3 ( RDW ≥ 16.2 % ), HR = 2.07 , 95% CI = 1.59 – 2.69 . The following results were obtained when RDW was treated as a continuous variable: HR = 1.11 , 95 % CI = 1.06 – 1.15 . The P values of the interaction between the RDW and covariates were greater than 0.05. Conclusion. RDW is a new independent prognostic marker for patients with sepsis-induced ARDS.

scholarly journals Extracorporeal Membrane Oxygenation in Immunocompromised Patients With Acute Respiratory Distress Syndrome—A Retrospective Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Chiao-Feng Cheng ◽  
You-Yi Chen ◽  
Ming-Chieh Shih ◽  
Yi-Min Huang ◽  
Li-Jung Tseng ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Cohort Study ◽  
Autoimmune Disease ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Retrospective Cohort ◽  
Distress Syndrome ◽  
Pulmonary Hemorrhage ◽  
Immunocompromised Patients ◽  
Immunocompromised Status

Objective: Although the negative impact of immunosuppression on survival in patients with acute respiratory distress syndrome (ARDS) treated by extracorporeal membrane oxygenation (ECMO) is well known, short-term outcomes such as successful weaning rate from ECMO and subgroups benefit most from ECMO remain to be determined. The aims of this study were (1) to identify the association between immunocompromised status and weaning from ECMO in patients of ARDS, and (2) to identify subgroups of immunocompromised patients who may benefit from ECMO.Methods: This retrospective cohort study enrolled patients who received ECMO for ARDS from 2010 to 2020. Immunocompromised status was defined as having a hematological malignancy, active solid tumor, solid organ transplant, or autoimmune disease.Results: This study enrolled 256 ARDS patients who received ECMO, of whom 68 were immunocompromised. The multivariable analysis showed that immunocompromised status was not independently associated with failure to wean from ECMO. In addition, the patients with an autoimmune disease (14/24, 58.3%) and organ transplantation (3/3, 100%) had a numerically higher weaning rate from ECMO than other immunocompromised patients. For causes of ARDS, most patients with pulmonary hemorrhage (6/8, 75%) and aspiration (5/9, 55.6%) could be weaned from ECMO, compared to only a few of the patients with interstitial lung disease (2/9, 22.2%) and sepsis (1/4, 25%).Conclusions: Immunocompromised status was not an independent risk factor of failure to wean from ECMO in patients with ARDS. For patients with pulmonary hemorrhage and aspiration-related ARDS, ECMO may be beneficial as bridge therapy.

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