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Discussion

ARDS common in your ICU?

I am a nursing student and currently in a critical care class. We studied ARDS today and I was wondering how common is this issue in your unit? Have any of you seen any better outcomes with interventions with being done to treat it? My instructor said most interventions do not change the mortality rate of 50-70%.

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    Your instructor is looking at old statistics. The death rate is now about 40%. This is due to advances in recognizing and providing more effective therapies.

    www.ardsusa.org

    For individual hospitals it would depend on the ICU. What type of ICU is it and what type of patients are seen? If it is a "trauma ICU", what level trauma center is the hospital?What type of equipment and physicians are available? Do they try to manage the patients to the best of their limited ability rather than transferring? Are there reasons the patients are not transferred to an ICU capable of handling more intense patients? Even so of the biggest trauma centers might have outdated equipment in their ICUs.

    A small ICU which might only see 4 ARDS patients a year that they keep may have 2 die which would bring that statistic to 50%. All 4 might die because they didn't transfer for whatever reason and that would be 100%. But, for the national stats and more current info, go to the website I posted.

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    we are a level 1 trauma center and i work in the Trauma ICU of 20 beds. We have a pretty decent amount of ARDS patients or patients who we place on the ARDS Protocol. I do no know the statistics regarding mortality. We frequently prone patients to help lossen up secretions also! very fun! :)

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    ARDS is seen in all kinds of ICU's from Medical, Surgical, Trauma, Burn, Cardiac and Neuro. While the mainstay of therapy is supportive care with lung protective ventilator strategies, true ARDS patients should be referred and transferred early to centers with experience in its management and who have the capability to provide rescue therapies in refractory patients (proning, ECLS). A center does not have to be Level I Trauma to be capable of providing high level of ARDS care.

    Our facility is not a designated Level I Trauma Center but we do have ECLS capabilities and is a referral center for ARDS in the greater metro area. We are a participant in the ARDS Network which includes a national network of academic and tertiary medical centers involved in clinical trials in new treatments for ARDS sponsored by NIH: Network Sites | NHLBI ARDS Network

    And I agree that ARDS mortality is no longer 50-70%. Recent published literature show the current mortality rates in the 40% range:

    http://www.atsjournals.org/doi/full/10.1164/rccm.200805-722OC

    http://www.ncbi.nlm.nih.gov/pubmed/18263687

    http://ccforum.com/content/2/1/29

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