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The impact of the acute respiratory distress syndrome on outcome after oesophagectomy.

Howells, P and Thickett, D and Knox, C and Park, D and Gao, Fang and Tucker, O and Whitehouse, T and McAuley, D and Perkins, Gavin D (2016) The impact of the acute respiratory distress syndrome on outcome after oesophagectomy. British journal of anaesthesia, 117 (3). pp. 375-81. ISSN 1471-6771.

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Official URL: http://bja.oxfordjournals.org/content/117/3/375.lo...

Abstract

BACKGROUND

The Acute Respiratory Distress Syndrome (ARDS) is a serious complication of major surgery and consumes substantial healthcare resources. Oesophagectomy is associated with high rates of ARDS. The aim of this study was to characterize patients and identify risk factors for developing ARDS after oesophagectomy.

METHODS

A secondary analysis of data from 331 patients gathered during the Beta Agonists Lung Injury Prevention Trial was undertaken. Characteristics and outcomes of patients with early (first 72 h postoperatively) and late (after 72 h) ARDS were determined. Linear and multivariate regression analysis was used to study the differences between early and late ARDS and identify risk factors.

RESULTS

ARDS was associated with more non-respiratory organ failure (early 44.1%, late 75.0%, no ARDS 27.6% P<0.001), longer ICU stay (mean early 12.1, late 20.2, no ARDS 7.3 days P<0.001) and longer hospital stay (mean early 18.1, late 24.5, no ARDS 14.2 days P<0.001) but no difference in mortality or quality of life. Older patients (OR 1.06 (1.00 to 1.13), P=0.045) and those with mid-oesophageal tumours (OR 7.48 (1.62-34.5), P=0.010) had a higher risk for ARDS.

CONCLUSIONS

Early and late ARDS after oesophagectomy increases intensive care and hospital length of stay. Given the high incidence of ARDS, cohorts of patients undergoing oesophagectomy may be useful as models for studies investigating ARDS prevention and treatment. Further investigations aimed at reducing perioperative ARDS are warranted.

Item Type: Article
Subjects: WB Practice of medicine > WB400 Intensive care
WT Geriatrics. Elderly care
Divisions: Clinical Support > Critical Care
Emergency Services > Elderly
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Depositing User: Mrs Caroline Tranter
Date Deposited: 13 Jan 2017 14:05
Last Modified: 13 Jan 2017 14:34
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1110

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