Document Detail


Body mass index is associated with the development of acute respiratory distress syndrome.
MedLine Citation:
PMID:  19770169     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The relationship between body mass index (BMI) and development of acute respiratory distress syndrome (ARDS) is unknown.
METHODS: A cohort study of critically ill patients at risk for ARDS was carried out. BMI was calculated from admission height and weight. Patients were screened daily for AECC (American European Consensus Committee)-defined ARDS and 60-day ARDS mortality.
RESULTS: Of 1795 patients, 83 (5%) patients were underweight (BMI <18.5 kg/m(2)), 627 (35%) normal (BMI 18.5-24.9), 605 (34%) overweight (BMI 25-29.9), 364 (20%) obese (BMI 30-39.9) and 116 (6%) severely obese (BMI > or =40). Increasing weight was associated with younger age (p<0.001), diabetes (p<0.0001), higher blood glucose (p<0.0001), lower prevalence of direct pulmonary injury (p<0.0001) and later development of ARDS (p = 0.01). BMI was associated with ARDS on multivariate analysis (OR(adj) 1.24 per SD increase; 95% CI 1.11 to 1.39). Similarly, obesity was associated with ARDS compared with normal weight (OR(adj) 1.66; 95% CI 1.21 to 2.28 for obese; OR(adj) 1.78; 95% CI 1.12 to 2.92 for severely obese). Exploratory analysis in a subgroup of intubated patients without ARDS on admission (n = 1045) found that obese patients received higher peak (p<0.0001) and positive end-expiratory pressures (p<0.0001) than non-obese patients. Among patients with ARDS, increasing BMI was associated with increased length of stay (p = 0.007) but not with mortality (OR(adj) 0.89 per SD increase; 95% CI 0.71 to 1.12).
CONCLUSION: BMI was associated with increased risk of ARDS in a weight-dependent manner and with increased length of stay, but not with mortality. Additional studies are needed to determine whether differences in initial ventilator settings may contribute to ARDS development in the obese.
Authors:
M N Gong; E K Bajwa; B T Thompson; D C Christiani
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural     Date:  2009-09-21
Journal Detail:
Title:  Thorax     Volume:  65     ISSN:  1468-3296     ISO Abbreviation:  Thorax     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-23     Completed Date:  2010-04-19     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  44-50     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Body Mass Index*
Body Weight
Critical Illness
Epidemiologic Methods
Female
Humans
Male
Middle Aged
Obesity / complications*
Respiratory Distress Syndrome, Adult / etiology*,  mortality
Grant Support
ID/Acronym/Agency:
HL084060/HL/NHLBI NIH HHS; HL086667/HL/NHLBI NIH HHS; HL60197/HL/NHLBI NIH HHS; K23 HL087934/HL/NHLBI NIH HHS; L32 MD000662/MD/NIMHD NIH HHS; L32 MD000662-02/MD/NIMHD NIH HHS
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