Pulmonary and Extrapulmonary causes of Acute Respiratory Distress Syndrome (ARDS) with thrombocytopenia in adults admitted in Intensive care areas in a tertiary care hospital

Pardeshi P; De A; Baveja S

Volume : V, Issue : X, October - 2016

Pulmonary and Extrapulmonary causes of Acute Respiratory Distress Syndrome (ARDS) with thrombocytopenia in adults admitted in Intensive care areas in a tertiary care hospital

Pardeshi P, De A, Baveja S

Abstract :

Background:Acute Respiratory Distress Syndrome (ARDS) is caused by pulmonary injuries to the lung like community acquired pneumonia (CAP), aspiration, trauma, tuberculosis, etc. and extrapulmonary injuries like sepsis, malaria, leptospirosis, etc. Patients with ARDS may develop thrombocytopenia. There are very few documented studies on comparison of pulmonary and extrapulmonary causes of ARDS patients with thrombocytopenia. Objectives: This study aimed to find out the pulmonary and extrapulmonary causes of ARDS, to correlate the biochemical parameters in these two groups and to assess the prognostic factors of ARDS patients. Materials and Method: This prospective observational study enrolled 100 consecutive cases of ARDS with thrombocytopenia admitted to Medical and Respiratory Intensive Care Units of a tertiary care hospital, over a period of one year. Results: Incidence of ARDS with thrombocytopenia was 10.26 %. ARDS due to extrapulmonary causes were in 79% cases, commonest being acute feile illness (AFI) in 28%, followed by malaria in 16%. ARDS due to pulmonary causes were 21%, commonest being CAP in 17%. Overall mortality was 49% which was more in pulmonary causes (66.6%). Percentage of cases as well as mortality was more in age group > 60 years. Expired patients had significantly lower hemoglobin and PaO2/FiO2 as compared to survived patients. Conclusion: Acute feile illness, community acquired pneumonia and malaria were the predominant causes of ARDS. Percentage of ARDS cases due to tropical illnesses were quite high, which can be prevented by early diagnosis and proper treatment of these diseases. Low hemoglobin, low PaO2/FiO2 and old age were significant predictors of mortality in adult ARDS patients with thrombocytopenia admitted in ICUs.