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Pulmonary Diffusion Capacity and Quality of Life during a Period of 6 Years in Patients who Survived Acute Respiratory Distress Syndrome

Lamot LE, Quispe Laime AM, Fiore C, Martinez LR, Bettini JE, De Salvo AB, Fuks VE, Petasny M

Introduction: Patients who survived Acute Respiratory Distress Syndrome (ARDS) may present long term physical damage that affects their quality of life and respiratory capacity. Restrictive ventilatory disorders, decrease in pulmonary diffusing capacity and changes in quality of life were observed.

Objective: Know whether there are changes in pulmonary function and quality of life of patients who were discharged from the Intensive Care Unit (ICU) from 2008 to 2013, who required mechanical ventilation and presented ARDS.

Methods and Materials: Descriptive study: Observational study.

Inclusion criteria: Patients older than 18 years old, who required Mechanical ventilation, presented ARDS and have been discharged from the ICU for 12 months or more.

Exclusion criteria: Patients with severe ARDS caused by influenza or incapable of performing respiratory function studies. This study was conducted with institutional approval and informed consent. The following tests were carried out: Self-administered quality of life questionary (EQ–5D), spirometry, 6-minute walking test(6MWT), pulmonary diffusion test for CO (DLco), and lung volumes by nitrogen dilution performed with the computerized equipment Ultima™ Series Med Graphics.

Results: 13 patients were studied. The median age was 42 ± 15 years old, 76.9% male. Quality life perception shows through EQ-5D changes in the 5 components. The biggest change occurred in the pain/discomfort dimension with a median of 1.62 ± 0.506, and the EQ% health was 80.77% ± 12.05. The median values of the rates (FEV1, FVC, FEV1/FVC, FEF25/75) were over 80%. 5 patients presented a mild restrictive pattern.

Lung volumes and DLco showed median over 80%. 4 patients presented a mild alteration in diffusion and one of them presented desaturation during the 6MWT. Correlation between DLco% and EQ% health p=0.294, EQ% health- TTO p=0.001 and EQ% health-VAS p=0.001.

Conclusion: Our results suggest that patients with mechanical ventilation and severe ARDS who were evaluated after a year of being discharged from the ICU present mild pulmonary sequels and their quality of life was moderately affected. These results are similar to what is reported in the bibliography. A limitation to the study is the small size of the sample.