[Acute Respiratory Distress Syndrome in Burns: Epidemiology and Factors Associated with Mortality].

Abstract

Acute respiratory distress syndrome (ARDS) is a common pathology in the intensive care unit associated with high mortality, especially in burn patients. A retrospective descriptive and univariate study was conducted in the intensive burn care unit over 4 years, from January 2018 to December 2021. Patients who developed ARDS during their stay according to the Berlin definition 2012 were included. One thousand one hundred and fifty patients were admitted, 360 were intubated (31%), of whom 100 presented an ARDS complication (28%). The average age was 40±13 years with a sex ratio of 1.8. The mean acute physiology and chronic health evaluation (APACHE) and severity simplified index (IGSII) were respectively 18(15-21) and ±34(29-42). The mean total body surface area burned was 46%±18, mean abbreviated burn severity index (ABSI) was 7,6±2,5. ARDS was severe among 60% (n=60) of cases and moderate in 40% (n=40) of cases, with a mean delay of occurrence from burns of 5.8±4 days. ARDS was due to infection in 56 patients, inhalation injury in 22 patients, and mixed etiology in 22 patients. The main complications observed were nosocomial infections among 71% of patients and acute kidney failure among 36% of patients. The mean duration of mechanical ventilation was 12,6±5,3 days and the mean length of stay in the intensive care unit was 13,7±5 days. Mortality was 61% (n=61). In multivariate analysis, independent mortality risk factors were identified: surface area burned greater than 39% (p=0,02), severity simplified index (IGSII) higher than 27 (p<10-3), APACHE II higher than 14,5 (p=0,01), the presence of pulmonary burns (p<10-3) and the occurrence of shock during resuscitation (p=0,04).