Clinical Characteristics and Outcomes of Sepsis-Related vs Non-Sepsis-Related ARDS

Abstract

Background: Acute Respiratory Distress Syndrome (ARDS) is a life-threatening condition with diverse etiologies. Sepsis-related ARDS presents unique challenges in management and outcomes compared to non-sepsis-related ARDS. Understanding these differences is crucial for optimizing clinical interventions and improving patient outcomes.
Materials and Methods: A retrospective cohort study was conducted, involving patients admitted to the intensive care unit (ICU) with ARDS between October 2022 and September 2023. Data on demographics, comorbidities, severity of illness, ventilator settings, and
outcomes were collected and analyzed. Patients were stratified into sepsis-related ARDS and non-sepsis-related ARDS groups based on clinical criteria.
Results: A total of 500 patients with ARDS were included in the study, among which 250 were sepsis-related ARDS and 250 were non-sepsis-related ARDS. The sepsis-related ARDS group had a higher proportion of comorbidities such as diabetes (45% vs 30%, p < 0.05) and hypertension (55% vs 40%, p < 0.05) compared to the non-sepsis-related ARDS group. Furthermore, sepsis-related ARDS was associated with higher severity scores on admission (APACHE II score: 25 ± 5 vs 20 ± 4, p < 0.001). Ventilator settings, including positive endexpiratory pressure (PEEP) and FiO2, were similar between the two groups. However, the sepsis-related ARDS group had a longer duration of mechanical ventilation (10 ± 3 days vs 8 ± 2 days, p < 0.01) and ICU stay (15 ± 4 days vs 12 ± 3 days, p < 0.05) compared to the nonsepsis-related ARDS group. Mortality rates were significantly higher in sepsis-related ARDS compared to non-sepsis-related ARDS (40% vs 25%, p < 0.01).
Conclusion: Sepsis-related ARDS presents with distinct clinical characteristics and worse outcomes compared to non-sepsis-related ARDS. Patients with sepsis-related ARDS have  higher severity scores, longer duration of mechanical ventilation and ICU stay, and higher mortality rates. Tailored interventions addressing the unique challenges posed by sepsisrelated ARDS are warranted to improve patient outcomes.