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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 p...

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Autores principales: Kim, Joohae, Choi, Sun Mi, Lee, Jinwoo, Park, Young Sik, Lee, Chang Hoon, Yim, Jae-Joon, Yoo, Chul-Gyu, Kim, Young Whan, Han, Sung Koo, Lee, Sang-Min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Critical Care Medicine 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6786717/
https://www.ncbi.nlm.nih.gov/pubmed/31723629
http://dx.doi.org/10.4266/kjccm.2016.00976
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author Kim, Joohae
Choi, Sun Mi
Lee, Jinwoo
Park, Young Sik
Lee, Chang Hoon
Yim, Jae-Joon
Yoo, Chul-Gyu
Kim, Young Whan
Han, Sung Koo
Lee, Sang-Min
author_facet Kim, Joohae
Choi, Sun Mi
Lee, Jinwoo
Park, Young Sik
Lee, Chang Hoon
Yim, Jae-Joon
Yoo, Chul-Gyu
Kim, Young Whan
Han, Sung Koo
Lee, Sang-Min
author_sort Kim, Joohae
collection PubMed
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.
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spelling pubmed-67867172019-11-13 Effect of Renin-Angiotensin System Blockage in Patients with Acute Respiratory Distress Syndrome: A Retrospective Case Control Study Kim, Joohae Choi, Sun Mi Lee, Jinwoo Park, Young Sik Lee, Chang Hoon Yim, Jae-Joon Yoo, Chul-Gyu Kim, Young Whan Han, Sung Koo Lee, Sang-Min Korean J Crit Care Med Original Article 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. Korean Society of Critical Care Medicine 2017-05 2017-05-31 /pmc/articles/PMC6786717/ /pubmed/31723629 http://dx.doi.org/10.4266/kjccm.2016.00976 Text en Copyright © 2017 The Korean Society of Critical Care Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Joohae
Choi, Sun Mi
Lee, Jinwoo
Park, Young Sik
Lee, Chang Hoon
Yim, Jae-Joon
Yoo, Chul-Gyu
Kim, Young Whan
Han, Sung Koo
Lee, Sang-Min
Effect of Renin-Angiotensin System Blockage in Patients with Acute Respiratory Distress Syndrome: A Retrospective Case Control Study
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 Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6786717/
https://www.ncbi.nlm.nih.gov/pubmed/31723629
http://dx.doi.org/10.4266/kjccm.2016.00976
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