Scientists say a new diagnostic tool may help doctors catch patients most at risk for acute respiratory (ARDS) failure following surgery.
Daryl J. Kor of the Mayo Clinic analyzed data from a large clinical trial spanning 22 medical centers, finding 1,562 patients who’d previously been identified as high risk for suffering ARDS, a condition that affects 200,000 Americans every year. Finding that 7.5 percent of that group had later developed the condition, the researchers revised the old diagnostic previously used to assess ARDS risk for candidates for elective surgery.
"It's certainly true in this case that an ounce of prevention is worth a pound of cure," Kor said in a statement. "But our ability to predict who is at risk has been limited. By identifying those who are at highest risk with better accuracy, we can begin to take steps toward preventing this dangerous and costly surgical complication."
The condition may arise as a result of smoke inhalation, pneumonia, or blood infection, though high-risk patients may develop ARDS after surgery. Sadly, the condition is hard to treat and kills patients about 30 percent of the time. Although surgeons may manage the risk of ARDS by restricting the volume of fluids and using alternative lung-ventilating methods, the blanket approach is time-consuming given that only three percent of patients at risk eventually develop the condition.
Thus, the researchers say the new diagnostic may help doctors focus on ARDS prevention among those most susceptible, with a risk level based on one or more of nine predictors associated with the condition, including blood infection, liver disease, emergency surgery, and an increased respiratory rate among others.
"Previous efforts have largely focused on treating ARDS well after it's onset," Kor said. "There has not been a lot of success with that strategy. If the new prediction tool is validated by other studies, it could be used as a screening mechanism to identify patients at greatest risk for ARDS, thereby facilitating its prevention as well as associated complications and death."
Aside from the new diagnostic, researchers at the National Heart, Lung, and Blood Institute continue work on a multi-hospital clinical trial of ARDS treatments. In good news, the American Lung Association says the incidence of ARDS is continuing to fall in the United States as treatment improves.