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Understanding and improving the long-term sequelae of ARDS.

Article Excerpt
What are the long-term sequelae of acute respiratory distress syndrome (ARDS)? Have there been any recent advances in improving patient outcomes?

* Recent research has been instrumental to understanding the long-term sequelae of acute lung injury (ALI)/ARDS. The information we present here is based on a recent review of this topic. (1) It is important to note that since patients' baseline status is not usually known, the understanding of long-term outcomes is frequently based on an imperfect comparison with population norms. These norms may not accurately represent the baseline status of patients with ALI, since these patients may be less healthy than the general population.

The major sequelae

The 6 general categories of the common sequelae of ALI are pulmonary, neuromuscular, physical function, neurocognitive, psychiatric, and quality of life (QOL).

* Pulmonary sequelae: Most ALI survivors initially have some impairment in lung function. (1,2) A reduction in carbon monoxide--diffusing capacity is the most common abnormality; it persists for at least 1 to 2 years after the patient is discharged. (1,2) Obstructive and restrictive defects in pulmonary function also are common and are typically mild.

* Neuromuscular sequelae: Neuromuscular weakness and other musculoskeletal problems are important in patients with ALI because they attribute these sequelae to impaired physical function, which is experienced during the first year of recovery. (2) The cause...

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