Practice of Diagnosis and Management of Acute Respiratory Distress Syndrome in Mainland China: a Cross-sectional Study

Overview

Journal J Thorac Dis

Publisher AME Publishing Company

Specialty Pulmonary Medicine

Date 2018 Nov 13

PMID 30416787

Citations 22

Authors

Ling Liu

Yi Yang

Zhiwei Gao

Maoqin Li

Xinwei Mu

Xiaochun Ma

Guicheng Li

Wen Sun

Xue Wang

Qin Gu

Ruiqiang Zheng

Hongsheng Zhao

Dan Ao

Wenkui Yu

Yushan Wang

Kang Chen

Jie Yan

Jianguo Li

Guolong Cai

Yurong Wang

Hongliang Wang

Yan Kang

Arthur S Slutsky

Songqiao Liu

Jianfen Xie

Haibo Qiu

Affiliations

Soon will be listed here.

Abstract

Background: Although acute respiratory distress syndrome (ARDS) has been recognized for more than 50 years, limited information exists about the incidence and management of ARDS in mainland China. To evaluate the potential for improvement in management of patients with ARDS, this study was designed to describe the incidence and management of ARDS in mainland China.

Methods: National prospective multicenter observational study over one month (August 31 to September 30, 2012) of all patients who fulfilled the Berlin or American European Consensus Conference (AECC) definition of ARDS in 20 intensive care units, with data collection related to the management of ARDS, patient characteristics and outcomes.

Results: Of the 1,814 patients admitted during the enrollment period, 149 (8.2%) and 147 (8.1%) patients were diagnosed by AECC and Berlin definition, respectively. Lung protective strategy with low tidal volume (Vt) (≤8 mL/kg) and limitation of the plateau pressure (Pplat) (≤30 cmHO) was performed in 75.2% patients. And, 36%, 21.1% and 4.1% patients with severe, moderate and mild ARDS had the driving pressure more than 14 cmHO (P<0.05). Pplat and driving pressure increased significantly in patients with a higher degree of ARDS severity (P=0.002 and P<0.001, respectively), but Vt were comparable in the three groups (P>0.05). In severe ARDS, patient median positive end expiratory pressure (PEEP) was 10.0 (8.0-11.3) cmHO and median FiO was 90%. A recruitment maneuver was performed in 35.5% of the patients, and 8.7% of patients with severe ARDS received prone position. Overall hospital mortality was 34.0%. Hospital mortality was 21.8% for mild, 31.1% for moderate, and 60.0% for patients with severe ARDS (P=0.004).

Conclusions: Despite general acceptance of low Vt and limited Pplat, high driving pressure, low PEEP and low use of adjunctive measures may still be a concern in mainland China, especially in patients with severe ARDS.

Trial Registration: ClinicalTrials.gov NCT01666834; date of registration release: August 14 2012.

Citing Articles

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Ma W, Tang S, Yao P, Zhou T, Niu Q, Liu P Signal Transduct Target Ther. 2025; 10(1):75.

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Knowledge, attitudes and practices of intensive care unit physicians towards the management of acute respiratory distress syndrome in China: a cross-sectional survey.

Qin Z, Zhao X, Meng Y, Wu Y, Qian J, Yin M BMJ Open. 2025; 15(1):e092069.

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