Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Acute respiratory distress syndrome: Study IDs surgical patients at risk

22.04.2014

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:

  • Acute respiratory distress syndrome developed in 117, or 7.5 percent. 
  • Nine independent factors are predictors of the syndrome: sepsis; high-risk aortic vascular surgery; high-risk cardiac surgery; emergency surgery; cirrhosis; admission to the hospital unit from a location other than home, such as a nursing home or another hospital; increased respiratory rate; and two measurements that indicate hypoxemia, a lower-than-normal oxygen level in the blood. 
  • Identifying those nine risk factors for surgical patients allowed researchers to refine previous risk prediction models; the new model can be used to identify high-risk patients before surgery for possible participation in acute respiratory distress syndrome prevention studies. 

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: newsbureau@mayo.edu

Sharon Theimer | Eurek Alert!

More articles from Health and Medicine:

nachricht Why might reading make myopic?
18.07.2018 | Universitätsklinikum Tübingen

nachricht Unique brain 'fingerprint' can predict drug effectiveness
11.07.2018 | McGill University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

Im Focus: Chemical reactions in the light of ultrashort X-ray pulses from free-electron lasers

Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.

Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

Global study of world's beaches shows threat to protected areas

19.07.2018 | Earth Sciences

New creepy, crawly search and rescue robot developed at Ben-Gurion U

19.07.2018 | Power and Electrical Engineering

Metal too 'gummy' to cut? Draw on it with a Sharpie or glue stick, science says

19.07.2018 | Materials Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>