ACUTE LUNG INJURY AT BARAGWANATH ICU - AN 8-MONTH AUDIT AND CALL FOR CONSENSUS FOR OTHER ORGAN FAILURE IN THE ADULT RESPIRATORY-DISTRESS SYNDROME

To test the expanded definition of acute lung injury (ALI), we prospec tively, over a period of 8 months, studied all adult ICU admissions wh o fitted the definition. Our study consisted of 83 patients with the a dult respiratory distress syndrome (ARDS) and 60 with mild to moderate ALI. Sepsis and trauma were the most common diagnoses on admission. T he overall mortality rate was 45 percent for ARDS and 38 percent in th e other group. Mortality rose significantly with associated other orga n failure, the incidence of which was as follows: hepatic, 39 percent; cardiac, 38 percent; hematologic, 22 percent; renal 21 percent; neuro logic, 5 percent. Sepsis syndrome eventually occurred in 73 percent an d septic shock in 38 percent of all cases of ALI. We found the expande d definition a useful grading system and consider this definition of A RDS to be currently the best. There are, however, problems with the de termination of lung compliance, the effect of inverse ratio ventilatio n, and the lack of consensus in defining other organ failure.