Wednesday, November 16, 2005

ARDS and pulmonary function

From a PCP in NC:

"Quick question: what PFT parameter is the last to normalize (if it ever does) in patients with ARDS, 1 year out?" The pulmonary boards were yesterday so some of you fellows out there should have no problem with this question.....

2 comments - CLICK HERE to read & add your own!:

Mendez said...

DLCO - (see NEJM v348no.8-One year outcomes in Survivors of ARDS). They looked at Fev1, FVC, TLC, DLCO. The only parameter siginificantly decreased at 12 mos was DLCO. I don't know if they reported or investigated other parameters suchs as MVV (which theoretically could still be low given persistent muscle weakness and fatigue at one year reported by subjects).

Jeff H said...

There are surprisingly little data regarding long-term changes in pulmonary function following ARDS. Most data suggest that (in survivors), there is steady improvement and normalization in FEV1, and FVC, for about a year following ARDS. The DLCO seem to improve at similar rates, but after a year the DLCO remains mildly impaired in this population.
--Herridge et al. NEJM 2003
--Lee and Hudson, Seminars in Respiratory and Critical Care Medicine 2001
--Neff et al. Chest 2003

A recent report shows that "at 12 months, lung spirometry tests demonstrated mild abnormalities that were stable over time (64% and 49% had <80% predicted forced expiratory volume in 1 sec [Fev1] and forced vital capacity [Fvc], respectively)."
--Heyland, Crit Care Med. 2005 Jul;33(7):1549-56.