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Epidemiology, lung mechanics and outcomes of ARDS: A comparison between pregnant and non‐pregnant subjects

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Purpose: We describe the epidemiology, lung mechanics and outcomes of acute respiratory distress syndrome (ARDS) complicating pregnancy. We also compare the outcomes of ARDS in pregnant and non‐pregnant females. Methods:… Click to show full abstract

Purpose: We describe the epidemiology, lung mechanics and outcomes of acute respiratory distress syndrome (ARDS) complicating pregnancy. We also compare the outcomes of ARDS in pregnant and non‐pregnant females. Methods: Retrospective observational study of all women admitted with ARDS. Results: 211 women with ARDS were admitted, which included 27 (12.8%) pregnant subjects. All were ventilated with a low tidal volume strategy. Most pregnant females presented during the third trimester. There was no difference in the lung compliance, the applied PEEP and the plateau pressures across trimesters. The pregnant females had a lower median age (25 [22–28] vs. 32 [22–42] years, p=0.003), higher proportion of severe ARDS (40.8% vs. 10.3%, p<0.0001), and higher driving pressure (18.2 vs. 15.5cm H2O, p=0.03) compared to non‐pregnant females. The maternal (18.5%) and perinatal (37%) mortality was high. However, the mortality was not different between pregnant and non‐pregnant subjects with ARDS. On a multivariate logistic regression analysis, the baseline APACHE II score, driving pressure and the delta SOFA score were independent predictors of mortality. Conclusions: ARDS complicating pregnancy is severe and is associated with high perinatal mortality. However, the outcomes of ARDS in pregnant females were similar to non‐pregnant females. HIGHLIGHTSThere is paucity of literature regarding the outcomes of acute respiratory distress syndrome (ARDS) complicating pregnancy.In this study, we describe our experience of ARDS complicating pregnancy.We found that the mortality of ARDS complicating pregnancy was similar to that of ARDS in the non‐pregnant womenThe development of ARDS during pregnancy was associated with a high perinatal mortality

Keywords: pregnancy; epidemiology; non pregnant; pregnant females; mechanics

Journal Title: Journal of Critical Care
Year Published: 2019

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