Acute respiratory distress syndrome is a leading cause of respiratory failure after surgery.
Patients who develop the lung disorder postoperatively are at higher risk of dying in the hospital, and those who survive the syndrome may still bear its physical effects years later.
A Mayo Clinic-led study is helping physicians better identify patients most at risk, the first step toward preventing this dangerous and costly surgical complication. They found nine independent risk factors, including sepsis, high-risk aortic vascular surgery, high-risk cardiac surgery, emergency surgery, cirrhosis of the liver, and admission to the hospital from a location other than home, such as a nursing home.
The findings are published in the journal Anesthesiology.
"This is a very common reason for needing an extended course of breathing support after surgery, and approximately 20 to 25 percent of patients who develop the syndrome will die from it," says first author Daryl Kor, M.D., a Mayo Clinic anesthesiologist. "It's well-documented that those who develop this syndrome stay in intensive care longer and in the hospital longer, and the impact of the syndrome can persist for many years."
Prevention of acute respiratory distress syndrome has become a priority for the National Institutes of Health's National Heart, Lung, and Blood Institute, the researchers noted.
To help prevent the condition, physicians first must identify who is most at risk, and that has proved difficult to do with individual patients, the researchers say. They studied 1,562 surgical patients considered at high risk of developing the syndrome, and found:
The findings may alter the way patients at high risk of the syndrome are cared for in the operating room, Dr. Kor says.
"For example, we may be a bit more conservative in the way we transfuse blood products. We may also ventilate their lungs in a little different way than we might if their risk score was low," Dr. Kor says. "We also hope that by identifying these high-risk patients, we might be able to better select a study population for future studies that look at specific prevention strategies. Before, such studies really weren't feasible because we couldn't identify high-risk groups with any degree of accuracy."
Future research may include studying the specific role that anesthetic care plays and whether aspects of care in the operating room should be modified in patients at high risk of developing the syndrome, Dr. Kor says.
Study co-authors included physicians and researchers from Mayo Clinic in Rochester and Jacksonville, Fla., and from Beth Israel Deaconess Medical Center, Albert Einstein College of Medicine, University of Texas Southwestern Medical Center, Duke University Medical Center, Massachusetts General Hospital, Wake Forest University Health Sciences, Brigham and Women's Hospital, University of Michigan School of Medicine and St. Joseph Mercy Hospital. The NIH-funded United States Critical Illness and Injury Trials Group collaborated on the study.
The study was supported by a career development grant from the Foundation for Anesthesia Education and Research in Rochester; by National Institutes of Health grants U01-HL108712-01, UL1 TR000135 and KL2 TR000136; and by the Mayo Clinic Critical Care Research Committee.
About Mayo Clinic
Recognizing 150 years of serving humanity in 2014, Mayo Clinic is a nonprofit worldwide leader in medical care, research and education for people from all walks of life. For more information, visit 150years.mayoclinic.org, MayoClinic.org or http://newsnetwork.mayoclinic.org/.
MEDIA CONTACT: Sharon Theimer, Mayo Clinic Public Affairs, 507-284-5005, Email: email@example.com
Sharon Theimer | Eurek Alert!
Researchers release the brakes on the immune system
18.10.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn
Norovirus evades immune system by hiding out in rare gut cells
12.10.2017 | University of Pennsylvania School of Medicine
University of Maryland researchers contribute to historic detection of gravitational waves and light created by event
On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...
Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.
Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....
Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).
When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...
Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.
How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...
Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.
It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...
17.10.2017 | Event News
10.10.2017 | Event News
10.10.2017 | Event News
19.10.2017 | Materials Sciences
19.10.2017 | Materials Sciences
19.10.2017 | Physics and Astronomy