• Onuma Chaiwat, Kaweesak Chittawatanarat, Annop Piriyapathsom, Chawika Pisitsak, Thammasak Thawitsri, Sunisa Chatmongkolchart, and Suneerat Kongsayreepong.
• J Med Assoc Thai. 2016 Sep 1; 99 Suppl 6: S118-S127.

ObjectiveThe incidence and outcomes of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) are unclear. We evaluated the cumulative incidence of, risk factors for, and outcomes of ALI/ARDS in surgical ICUs (SICUs).Material And MethodThe multicenter Thai University-based Surgical Intensive Care Unit (THAI-SICU) study was a prospective, observational cohort study including nine university-based SICUs throughout Thailand from April 2011 to January 2013. All >18-year-old surgical patients who were admitted to general SICUs were recruited. The primary outcome was the incidence of ALI/ARDS.ResultsIn total, 4,652 patients were analyzed. ALI/ARDS new developed in 114 patients (2.5%). Patients with ALI/ARDS had higher APACHE II (20.0 vs. 11.4, respectively; p<0.001) and SOFA scores (7.3 vs. 3.1, respectively; p<0.001) and a higher incidence of past or current smoking (48% vs. 36%, respectively; p<0.001) than the non-ARDS patients. The 28-day mortality rate was significantly higher in patients with than without ALI/ARDS (50% vs. 12%; p<0.001). Higher APACHE II and SOFA scores and higher rates of current or past smoking were independent predictors of ALI/ARDS.ConclusionThe incidence of ALI/ARDS in the THAI-SICU study was low, but the mortality rate was high. Higher severity scores and smoking were associated with ALI/ARDS.

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