Abstract：
PURPOSE:Acute Respiratory Distress Syndrome is a major complication of leptospirosis, leading to the majority of fatalities. METHODS:Retrospective, descriptive and single-center cohort study. The primary outcome was the Standardized Mortality Ratio (SMR) for ARDS in leptospirosis based on the quartiles of the SAPS2 score in the reference population of 1683 patients hospitalized for ARDS. The second outcomes were to determine the risk factors of mortality of ARDS in leptospirosis and to describe the cases requiring Extracorporeal Membrane Oxygenation (ECMO). RESULTS:Of 172 leptospirosis patients from January 2004 to October 2017, 39 (23%) presented a moderate or severe ARDS with a mortality rate of 23% (9 cases). Among patients with ARDS, the SMR with regards to Simplified Acute Physiology Score II was 0.49 (CI95%: 0.21; 0.96). Risk factors associated with mortality found by bivariate analysis were Severity Acute Physiology Score II (p = 0.01), Sequential Organ Failure Assessment (p = 0.01), base excess (p = 0.002), kaliemia (p = 0.004), bilirubinemia (p = 0.01) and level of aspartate aminotransferase (p = 0.01). Eight patients underwent ECMO for refractory ARDS and six survived. CONCLUSIONS:Leptospirosis can induce serious but transient ARDS with a better prognosis than that of other causes of ARDS. Several patients have been successfully treated with ECMO.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Vandroux D,Chanareille P,Delmas B,Gaüzère BA,Allou N,Raffray L,Jaffar-Bandjee MC,Martinet O,Ferdynus C,Jabot Jdoi
10.1016/j.jcrc.2019.02.018subject
Has Abstractpub_date
2019-06-01 00:00:00pages
165-169eissn
0883-9441issn
1557-8615pii
S0883-9441(18)31043-8journal_volume
51pub_type
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journal_title：Journal of critical care
pub_type： 杂志文章,随机对照试验
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journal_title：Journal of critical care
pub_type： 杂志文章,评审
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更新日期：2017-10-01 00:00:00
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更新日期：2018-06-01 00:00:00
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更新日期：2014-08-01 00:00:00
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更新日期：2017-12-01 00:00:00
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更新日期：2018-10-01 00:00:00
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更新日期：2017-06-01 00:00:00
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pub_type： 临床试验,杂志文章
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更新日期：2017-10-01 00:00:00
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journal_title：Journal of critical care
pub_type： 杂志文章
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更新日期：2016-02-01 00:00:00
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journal_title：Journal of critical care
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abstract：:The increasing role of simulation in medical education has paralleled the advancement of this technology. Full environment simulation (FES) can be used to effectively replicate rare medical catastrophes with exacting realism. It has been suggested that emotion can significantly enhance learning by producing memories t...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2007.12.003
更新日期：2008-06-01 00:00:00
abstract：BACKGROUND:A nationwide increase in the rate and severity of Clostridium difficile-associated disease may reflect infection with a virulent strain characterized by polymerase chain reaction as ribotype 027 (NAP1/B1). HYPOTHESIS:The high prevalence of ribotype 027 at our institution would allow investigation of the ris...
journal_title：Journal of critical care
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更新日期：2010-06-01 00:00:00
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更新日期：2015-02-01 00:00:00
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journal_title：Journal of critical care
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更新日期：2018-06-01 00:00:00
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pub_type： 杂志文章
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更新日期：2014-10-01 00:00:00
