Analysis of clinical characteristics of patients with acute diffuse lung changes and respiratory failure_West China Medical Journal

Authors：

LIU Chun ¹ ,  ZHENG Xiangde ¹ , LIU Jinping ² , LI Changlong ¹ , LI Wenbin ¹ , WU Changhui ¹

1. Department of Critical Care Medicine, Dazhou Central Hospital, Dazhou, Sichuan 635000, P. R. China;
2. Dazhou Vocational College of Traditional Chinese Medicine, Dazhou, Sichuan 635000, P. R. China;

Corresponding?author：

ZHENG Xiangde, Email: 109284521@qq.com

Keywords：

Acute diffuse lung changes; Acute respiratory distress syndrome; Disease characteristics

DOI：

10.7507/1002-0179.201911189

Video：

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Objective To summarize and analyze the clinical characteristics of patients with acute diffuse lung changes and respiratory failure.Methods The clinical data of patients in the Department of Critical Care Medicine, Dazhou Central Hospital between January 2016 and December 2018 were retrospectively collected, whose main clinical manifestation was acute respiratory distress syndrome with acute onset (<3 weeks) and main imaging manifestation was diffuse changes in both lungs. The clinical characteristics of patients were summarized, and the causes of the disease were explored.Results A total of 65 patients with acute diffuse lung changes and respiratory failure were enrolled, including 42 males (64.6%) and 23 females (35.4%). The average age was (57.1±18.4) years, the average time from onset to treatment was (7.5±5.9) d, and the average length of stay in the intensive care unit was (8.9±4.1) d. A total of 23 cases died, with a case-fatality rate of 35.4%. Among the 65 patients, there were 50 case (76.9%) of infectious diseases, including 36 cases of bacterial infections (including 4 cases of tuberculosis), 8 cases of viral infections (all were H1N1 infections), and 6 cases of fungal infections (including 1 case of pneumocystis infection); and there were 15 cases (23.1%) of non-infectious diseases, including 4 cases of acute left heart failure, 2 cases of interstitial pneumonia, 2 cases of vasculitis, 1 case of myositis dermatomyositis, 1 case of aspiration pneumonia, 1 case of acute pulmonary embolism, 1 case of acute drug lung injury, 1 case of neurogenic pulmonary edema, 1 case of drowning, and 1 case of unknown origin.Conclusions Infectious diseases are the main cause of acute diffuse lung changes and respiratory failure, while among non-infectious diseases, acute heart failure and immune system diseases are common causes.

Citation： LIU Chun, ZHENG Xiangde, LIU Jinping, LI Changlong, LI Wenbin, WU Changhui. Analysis of clinical characteristics of patients with acute diffuse lung changes and respiratory failure. West China Medical Journal, 2021, 36(1): 40-44. doi: 10.7507/1002-0179.201911189 Copy

1.	鄧彩霞, 湯展宏, 胡軍濤. 急性呼吸窘迫綜合征預后因素的研究進展. 廣西醫學, 2018, 40(10): 1216-1218.
2.	Papazian L, Calfee CS, Chiumello D, et al. Diagnostic workup for ARDS patients. Intensive Care Med, 2016, 42(5): 674-685.
3.	ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin definition. JAMA, 2012, 307(23): 2526-2533.
4.	糜麗云, 班承鈞, 劉艷, 等. 急性彌漫性肺浸潤性改變的臨床特征. 中華醫學雜志, 2017, 97(44): 3445-3449.
5.	Wong AK, Walkey AJ. Open lung biopsy among critically ill, mechanically ventilated patients. A meta analysis. Ann Am Thorac Soc, 2015, 12(8): 1226-1230.
6.	中華人民共和國衛生部. 甲型H1N1流感診療方案(2010 年版). 國際呼吸雜志, 2011, 31(2): 81-84.
7.	Woodhead M, Blasi F, Ewig S, et al. Guidelines for the management of adult lower respiratory tract infections--summary. Clin Microbiol Infect, 2011, 17(Suppl 6): 1-24.
8.	American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med, 2005, 171(4): 388-416.
9.	姚秀娟. 重癥彌漫性肺疾病 12 例支氣管鏡診斷分析. 福建醫藥雜志, 2016, 38(4): 120-122.
10.	范紅, 申永春, 童翔. 社區獲得性肺炎病原學變遷. 華西醫學, 2018, 33(1): 84-87.
11.	Aliberti S, Messinesi G, Gamberini S, et al. Non-invasive mechanical ventilation in patients with diffuse interstitial lung diseases. BMC Pulm Med, 2014, 14: 194.
12.	李一詩, 郭述良, 易祥華, 等. 經支氣管冷凍肺活檢對彌漫性肺疾病病因診斷的有效性和安全性. 中華醫學雜志, 2017, 97(46): 3617-3623.
13.	吳翔, 方愛珠, 章龍成, 等. 肺泡灌洗液細胞成分分析在彌漫性肺疾病中應用. 臨床軍醫雜志, 2017, 45(8): 857-859.
14.	Gibelin A, Parrot A, Maitre B, et al. Acute respiratory distress syndrome mimickers lacking common risk factors of the Berlin definition. Intensive Care Med, 2016, 42(2): 164-172.
15.	胡譯丹, 劉鋼, 謝其冰. 特發性炎性肌病相關的間質性肺疾病. 華西醫學, 2018, 33(12): 1544-1548.

1. 鄧彩霞, 湯展宏, 胡軍濤. 急性呼吸窘迫綜合征預后因素的研究進展. 廣西醫學, 2018, 40(10): 1216-1218.
2. Papazian L, Calfee CS, Chiumello D, et al. Diagnostic workup for ARDS patients. Intensive Care Med, 2016, 42(5): 674-685.
3. ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin definition. JAMA, 2012, 307(23): 2526-2533.
4. 糜麗云, 班承鈞, 劉艷, 等. 急性彌漫性肺浸潤性改變的臨床特征. 中華醫學雜志, 2017, 97(44): 3445-3449.
5. Wong AK, Walkey AJ. Open lung biopsy among critically ill, mechanically ventilated patients. A meta analysis. Ann Am Thorac Soc, 2015, 12(8): 1226-1230.
6. 中華人民共和國衛生部. 甲型H1N1流感診療方案(2010 年版). 國際呼吸雜志, 2011, 31(2): 81-84.
7. Woodhead M, Blasi F, Ewig S, et al. Guidelines for the management of adult lower respiratory tract infections--summary. Clin Microbiol Infect, 2011, 17(Suppl 6): 1-24.
8. American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med, 2005, 171(4): 388-416.
9. 姚秀娟. 重癥彌漫性肺疾病 12 例支氣管鏡診斷分析. 福建醫藥雜志, 2016, 38(4): 120-122.
10. 范紅, 申永春, 童翔. 社區獲得性肺炎病原學變遷. 華西醫學, 2018, 33(1): 84-87.
11. Aliberti S, Messinesi G, Gamberini S, et al. Non-invasive mechanical ventilation in patients with diffuse interstitial lung diseases. BMC Pulm Med, 2014, 14: 194.
12. 李一詩, 郭述良, 易祥華, 等. 經支氣管冷凍肺活檢對彌漫性肺疾病病因診斷的有效性和安全性. 中華醫學雜志, 2017, 97(46): 3617-3623.
13. 吳翔, 方愛珠, 章龍成, 等. 肺泡灌洗液細胞成分分析在彌漫性肺疾病中應用. 臨床軍醫雜志, 2017, 45(8): 857-859.
14. Gibelin A, Parrot A, Maitre B, et al. Acute respiratory distress syndrome mimickers lacking common risk factors of the Berlin definition. Intensive Care Med, 2016, 42(2): 164-172.
15. 胡譯丹, 劉鋼, 謝其冰. 特發性炎性肌病相關的間質性肺疾病. 華西醫學, 2018, 33(12): 1544-1548.

West China Medical Journal

Analysis of clinical characteristics of patients with acute diffuse lung changes and respiratory failure

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