Effect of Renin-Angiotensin System Blockage in Patients with Acute Respiratory Distress Syndrome: A Retrospective Case Control Study
Background Acute respiratory distress syndrome (ARDS) remains a life-threatening disease. Many patients with ARDS do not recover fully, and progress to terminal lung fibrosis. Angiotensin-converting enzyme (ACE) inhibitor is known to modulate the neurohormonal system to reduce inflammation and to pr...
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| Format: | Article |
| Language: | English |
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Korean Society of Critical Care Medicine
2017-05-01
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| Series: | Korean Journal of Critical Care Medicine |
| Subjects: | |
| Online Access: | http://www.kjccm.org/upload/pdf/kjccm-2016-00976.pdf |
| _version_ | 1811266451533725696 |
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| author | Joohae Kim Sun Mi Choi Jinwoo Lee Young Sik Park Chang Hoon Lee Jae-Joon Yim Chul-Gyu Yoo Young Whan Kim Sung Koo Han Sang-Min Lee |
| author_facet | Joohae Kim Sun Mi Choi Jinwoo Lee Young Sik Park Chang Hoon Lee Jae-Joon Yim Chul-Gyu Yoo Young Whan Kim Sung Koo Han Sang-Min Lee |
| author_sort | Joohae Kim |
| collection | DOAJ |
| description | Background Acute respiratory distress syndrome (ARDS) remains a life-threatening disease. Many patients with ARDS do not recover fully, and progress to terminal lung fibrosis. Angiotensin-converting enzyme (ACE) inhibitor is known to modulate the neurohormonal system to reduce inflammation and to prevent tissue fibrosis. However, the role of ACE inhibitor in the lungs is not well understood. We therefore conducted this study to elucidate the effect of renin-angiotensin system (RAS) blockage on the prognosis of patients with ARDS. Methods We analyzed medical records of patients who were admitted to the medical intensive care unit (ICU) at a tertiary care hospital from January 2005 to December 2010. ARDS was determined using the Berlin definition. The primary outcome was the mortality rate of ICU. Survival analysis was performed after adjustment using propensity score matching. Results A total of 182 patients were included in the study. Thirty-seven patients (20.3%) took ACE inhibitor or angiotensin receptor blocker (ARB) during ICU admission, and 145 (79.7%) did not; both groups showed similar severity scores. In the ICU, mortality was 45.9% in the RAS inhibitor group and 58.6% in the non-RAS inhibitor group (P = 0.166). The RAS inhibitor group required a longer duration of mechanical ventilation (29.5 vs. 19.5, P = 0.013) and longer ICU stay (32.1 vs. 20.2 days, P < 0.001). In survival analysis, the RAS inhibitor group showed better survival rates than the non-RAS group (P < 0.001). Conclusions ACE inhibitor or ARB may have beneficial effect on ARDS patients. |
| first_indexed | 2024-04-12T20:43:29Z |
| format | Article |
| id | doaj.art-2896d00b7eeb450bbc692d53da17a42e |
| institution | Directory Open Access Journal |
| issn | 2383-4870 2383-4889 |
| language | English |
| last_indexed | 2024-04-12T20:43:29Z |
| publishDate | 2017-05-01 |
| publisher | Korean Society of Critical Care Medicine |
| record_format | Article |
| series | Korean Journal of Critical Care Medicine |
| spelling | doaj.art-2896d00b7eeb450bbc692d53da17a42e2022-12-22T03:17:21ZengKorean Society of Critical Care MedicineKorean Journal of Critical Care Medicine2383-48702383-48892017-05-0132215416310.4266/kjccm.2016.009761092Effect of Renin-Angiotensin System Blockage in Patients with Acute Respiratory Distress Syndrome: A Retrospective Case Control StudyJoohae Kim0Sun Mi Choi1Jinwoo Lee2Young Sik Park3Chang Hoon Lee4Jae-Joon Yim5Chul-Gyu Yoo6Young Whan Kim7Sung Koo Han8Sang-Min Lee9 Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea Seoul National University Hospital and Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Seoul National University Hospital and Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Seoul National University Hospital and Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Seoul National University Hospital and Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Seoul National University Hospital and Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Seoul National University Hospital and Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Seoul National University Hospital and Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Seoul National University Hospital and Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Seoul National University Hospital and Department of Internal Medicine, Seoul National University College of Medicine, Seoul, KoreaBackground Acute respiratory distress syndrome (ARDS) remains a life-threatening disease. Many patients with ARDS do not recover fully, and progress to terminal lung fibrosis. Angiotensin-converting enzyme (ACE) inhibitor is known to modulate the neurohormonal system to reduce inflammation and to prevent tissue fibrosis. However, the role of ACE inhibitor in the lungs is not well understood. We therefore conducted this study to elucidate the effect of renin-angiotensin system (RAS) blockage on the prognosis of patients with ARDS. Methods We analyzed medical records of patients who were admitted to the medical intensive care unit (ICU) at a tertiary care hospital from January 2005 to December 2010. ARDS was determined using the Berlin definition. The primary outcome was the mortality rate of ICU. Survival analysis was performed after adjustment using propensity score matching. Results A total of 182 patients were included in the study. Thirty-seven patients (20.3%) took ACE inhibitor or angiotensin receptor blocker (ARB) during ICU admission, and 145 (79.7%) did not; both groups showed similar severity scores. In the ICU, mortality was 45.9% in the RAS inhibitor group and 58.6% in the non-RAS inhibitor group (P = 0.166). The RAS inhibitor group required a longer duration of mechanical ventilation (29.5 vs. 19.5, P = 0.013) and longer ICU stay (32.1 vs. 20.2 days, P < 0.001). In survival analysis, the RAS inhibitor group showed better survival rates than the non-RAS group (P < 0.001). Conclusions ACE inhibitor or ARB may have beneficial effect on ARDS patients.http://www.kjccm.org/upload/pdf/kjccm-2016-00976.pdfacute respiratory distress syndromeangiotensin-converting enzyme inhibitorsangiotensin receptor antagonistsmortalityrenin-angiotensin system |
| spellingShingle | Joohae Kim Sun Mi Choi Jinwoo Lee Young Sik Park Chang Hoon Lee Jae-Joon Yim Chul-Gyu Yoo Young Whan Kim Sung Koo Han Sang-Min Lee Effect of Renin-Angiotensin System Blockage in Patients with Acute Respiratory Distress Syndrome: A Retrospective Case Control Study Korean Journal of Critical Care Medicine acute respiratory distress syndrome angiotensin-converting enzyme inhibitors angiotensin receptor antagonists mortality renin-angiotensin system |
| title | Effect of Renin-Angiotensin System Blockage in Patients with Acute Respiratory Distress Syndrome: A Retrospective Case Control Study |
| title_full | Effect of Renin-Angiotensin System Blockage in Patients with Acute Respiratory Distress Syndrome: A Retrospective Case Control Study |
| title_fullStr | Effect of Renin-Angiotensin System Blockage in Patients with Acute Respiratory Distress Syndrome: A Retrospective Case Control Study |
| title_full_unstemmed | Effect of Renin-Angiotensin System Blockage in Patients with Acute Respiratory Distress Syndrome: A Retrospective Case Control Study |
| title_short | Effect of Renin-Angiotensin System Blockage in Patients with Acute Respiratory Distress Syndrome: A Retrospective Case Control Study |
| title_sort | effect of renin angiotensin system blockage in patients with acute respiratory distress syndrome a retrospective case control study |
| topic | acute respiratory distress syndrome angiotensin-converting enzyme inhibitors angiotensin receptor antagonists mortality renin-angiotensin system |
| url | http://www.kjccm.org/upload/pdf/kjccm-2016-00976.pdf |
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