OBJECTIVE: To compare the American-European Consensus Conference (AECC) definition of acute respiratory distress syndrome (ARDS) to autopsy findings. METHODS: All patients who died in the intensive care unit of the Federal University of Juiz de Fora University Hospital between 1995 and 2003 and were submitted to autopsy were included in the study. Patient clinical charts were reviewed to establish whether cases met the AECC criteria for a diagnosis of ARDS, histologically defined as the presence of diffuse alveolar damage (DAD). RESULTS: During the study period, 592 patients died, and 22 were submitted to autopsy. Of those 22 patients, 10 (45%) met the AECC criteria, and 7 (32%) met the histopathological criteria for DAD. The AECC clinical criteria presented a sensitivity of 71% (95%CI: 36-92%) and a specificity of 67% (95%CI: 42-85%). The positive and negative predictive values were, respectively, 50 and 83%, whereas the positive and negative likelihood ratios were, respectively, 2.33 and 0.47. The histopathological findings in the 5 patients who met AECC criteria but did not present DAD were pneumonia (n = 2), pulmonary embolism (n = 1), tuberculosis (n = 1), and cryptococcosis (n = 1). CONCLUSION: The accuracy of the AECC definition of ARDS was godless than satisfactory. Due to the low positive predictive value and the low positive likelihood ratio, other hypotheses must be considered when ARDS is suspected.
OBJECTIVE: To compare the American-European Consensus Conference (AECC) definition of acute respiratory distress syndrome (ARDS) to autopsy findings. METHODS: All patients who died in the intensive care unit of the Federal University of Juiz de Fora University Hospital between 1995 and 2003 and were submitted to autopsy were included in the study. Patient clinical charts were reviewed to establish whether cases met the AECC criteria for a diagnosis of ARDS, histologically defined as the presence of diffuse alveolar damage (DAD). RESULTS: During the study period, 592 patients died, and 22 were submitted to autopsy. Of those 22 patients, 10 (45%) met the AECC criteria, and 7 (32%) met the histopathological criteria for DAD. The AECC clinical criteria presented a sensitivity of 71% (95%CI: 36-92%) and a specificity of 67% (95%CI: 42-85%). The positive and negative predictive values were, respectively, 50 and 83%, whereas the positive and negative likelihood ratios were, respectively, 2.33 and 0.47. The histopathological findings in the 5 patients who met AECC criteria but did not present DAD were pneumonia (n = 2), pulmonary embolism (n = 1), tuberculosis (n = 1), and cryptococcosis (n = 1). CONCLUSION: The accuracy of the AECC definition of ARDS was godless than satisfactory. Due to the low positive predictive value and the low positive likelihood ratio, other hypotheses must be considered when ARDS is suspected.
Authors: José A Lorente; Pablo Cardinal-Fernández; Diego Muñoz; Fernando Frutos-Vivar; Arnaud W Thille; Carlos Jaramillo; Aida Ballén-Barragán; José M Rodríguez; Oscar Peñuelas; Guillermo Ortiz; José Blanco; Bruno Valle Pinheiro; Nicolás Nin; María del Carmen Marin; Andrés Esteban; Taylor B Thompson Journal: Intensive Care Med Date: 2015-09-18 Impact factor: 17.440
Authors: Alexandre de Matos Soeiro; Aline D Ruppert; Mauro Canzian; Vera L Capelozzi; Carlos V Serrano Journal: Clinics (Sao Paulo) Date: 2012 Impact factor: 2.365
Authors: Carmen Sílvia Valente Barbas; Alexandre Marini Isola; Augusto Manoel de Carvalho Farias; Alexandre Biasi Cavalcanti; Ana Maria Casati Gama; Antonio Carlos Magalhães Duarte; Arthur Vianna; Ary Serpa Neto; Bruno de Arruda Bravim; Bruno do Valle Pinheiro; Bruno Franco Mazza; Carlos Roberto Ribeiro de Carvalho; Carlos Toufen Júnior; Cid Marcos Nascimento David; Corine Taniguchi; Débora Dutra da Silveira Mazza; Desanka Dragosavac; Diogo Oliveira Toledo; Eduardo Leite Costa; Eliana Bernardete Caser; Eliezer Silva; Fabio Ferreira Amorim; Felipe Saddy; Filomena Regina Barbosa Gomes Galas; Gisele Sampaio Silva; Gustavo Faissol Janot de Matos; João Claudio Emmerich; Jorge Luis Dos Santos Valiatti; José Mario Meira Teles; Josué Almeida Victorino; Juliana Carvalho Ferreira; Luciana Passuello do Vale Prodomo; Ludhmila Abrahão Hajjar; Luiz Cláudio Martins; Luiz Marcelo Sá Malbouisson; Mara Ambrosina de Oliveira Vargas; Marco Antonio Soares Reis; Marcelo Brito Passos Amato; Marcelo Alcântara Holanda; Marcelo Park; Marcia Jacomelli; Marcos Tavares; Marta Cristina Paulette Damasceno; Murillo Santucci César Assunção; Moyzes Pinto Coelho Duarte Damasceno; Nazah Cherif Mohamad Youssef; Paulo José Zimmermann Teixeira; Pedro Caruso; Péricles Almeida Delfino Duarte; Octavio Messeder; Raquel Caserta Eid; Ricardo Goulart Rodrigues; Rodrigo Francisco de Jesus; Ronaldo Adib Kairalla; Sandra Justino; Sérgio Nogueira Nemer; Simone Barbosa Romero; Verônica Moreira Amado Journal: Rev Bras Ter Intensiva Date: 2014 Apr-Jun