No total, 10% a 15% dos pacientes internados em unidade de terapia intensiva preenchem os critérios para a síndrome do desconforto respiratório agudo (SDRA), com um aumento da incidência nos pacientes sob ventilação mecânica.[2]Frutos-Vivar F, Esteban A. Epidemiology of acute lung injury and acute respiratory distress syndrome. Curr Opin Crit Care. 2004 Feb;10(1):1-6.
http://www.ncbi.nlm.nih.gov/pubmed/15166842?tool=bestpractice.com
[3]Summers C, Singh NR, Worpole L, et al. Incidence and recognition of acute respiratory distress syndrome in a UK intensive care unit. Thorax. 2016 Nov;71(11):1050-1.
https://thorax.bmj.com/content/71/11/1050.full
http://www.ncbi.nlm.nih.gov/pubmed/27552782?tool=bestpractice.com
[4]Bellani G, Laffey JG, Pham T, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA. 2016 Feb 23;315(8):788-800.
https://jamanetwork.com/journals/jama/fullarticle/2492877
http://www.ncbi.nlm.nih.gov/pubmed/26903337?tool=bestpractice.com
A incidência da síndrome do desconforto respiratório agudo (SDRA) é estimada em 64 casos em 100,000 pessoas, ou 190,000 casos por ano nos EUA. Essa taxa de incidência é 2 a 40 vezes maior que as estimativas anteriores, o que provavelmente não representa um aumento de incidência, mas sim uma subestimativa histórica.[5]Rubenfeld GD, Caldwell E, Peabody E, et al. Incidence and outcomes of acute lung injury. N Engl J Med. 2005 Oct 20;353(16):1685-93.
http://www.ncbi.nlm.nih.gov/pubmed/16236739?tool=bestpractice.com
A incidência de SDRA pode ser maior nos EUA que na Europa e em outros países desenvolvidos, embora evidências sugiram que as taxas nos EUA podem estar em declínio.[6]MacCullum NS, Evans TW. Epidemiology of acute lung injury. Curr Opin Crit Care. 2005 Feb;11(1):43-9.
http://www.ncbi.nlm.nih.gov/pubmed/15659944?tool=bestpractice.com
[7]Li G, Malinchoc M, Cartin-Ceba R, et al. Eight-year trend of acute respiratory distress syndrome: a population-based study in Olmsted County, Minnesota. Am J Respir Crit Care Med. 2011 Jan 1;183(1):59-66.
https://www.atsjournals.org/doi/full/10.1164/rccm.201003-0436OC
http://www.ncbi.nlm.nih.gov/pubmed/20693377?tool=bestpractice.com
A doença crítica, o tabagismo e o consumo de bebidas alcoólicas são fatores predisponentes para a SDRA.[8]Moss M, Parsons PE, Steinberg KP, et al. Chronic alcohol abuse is associated with an increased incidence of acute respiratory distress syndrome and severity of multiple organ dysfunction in patients with septic shock. Crit Care Med. 2003 Mar;31(3):869-77.
http://www.ncbi.nlm.nih.gov/pubmed/12626999?tool=bestpractice.com
[9]Simou E, Leonardi-Bee J, Britton J. The effect of alcohol consumption on the risk of ARDS: a systematic review and meta-analysis. Chest. 2018 Jul;154(1):58-68.
https://journal.chestnet.org/article/S0012-3692(17)33280-4/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/29288645?tool=bestpractice.com
[10]Moazed F, Hendrickson C, Jauregui A, et al. Cigarette smoke exposure and acute respiratory distress syndrome in sepsis: epidemiology, clinical features, and biologic markers. Am J Respir Crit Care Med. 2022 Apr 15;205(8):927-35.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9838633
http://www.ncbi.nlm.nih.gov/pubmed/35050845?tool=bestpractice.com
A exposição prolongada a poluentes atmosféricos ambientais também aumenta o risco de desenvolvimento de SDRA.[11]Reilly JP, Zhao Z, Shashaty MGS, et al. Exposure to ambient air pollutants and acute respiratory distress syndrome risk in sepsis. Intensive Care Med. 2023 Aug;49(8):957-65.
http://www.ncbi.nlm.nih.gov/pubmed/37470831?tool=bestpractice.com
[12]Reilly JP, Zhao Z, Shashaty MGS, et al. Low to moderate air pollutant exposure and acute respiratory distress syndrome after severe trauma. Am J Respir Crit Care Med. 2019 Jan 1;199(1):62-70.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353017
http://www.ncbi.nlm.nih.gov/pubmed/30067389?tool=bestpractice.com
[13]Ware LB, Zhao Z, Koyama T, et al. Long-term ozone exposure increases the risk of developing the acute respiratory distress syndrome. Am J Respir Crit Care Med. 2016 May 15;193(10):1143-50.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4872663
http://www.ncbi.nlm.nih.gov/pubmed/26681363?tool=bestpractice.com
Sexo, etnia e raça não foram definitivamente associados à incidência de SDRA.
A mortalidade da SDRA é de, aproximadamente, 30% a 50%, embora a mortalidade em grandes ensaios clínicos pareça estar diminuindo em ritmo constante.[3]Summers C, Singh NR, Worpole L, et al. Incidence and recognition of acute respiratory distress syndrome in a UK intensive care unit. Thorax. 2016 Nov;71(11):1050-1.
https://thorax.bmj.com/content/71/11/1050.full
http://www.ncbi.nlm.nih.gov/pubmed/27552782?tool=bestpractice.com
[5]Rubenfeld GD, Caldwell E, Peabody E, et al. Incidence and outcomes of acute lung injury. N Engl J Med. 2005 Oct 20;353(16):1685-93.
http://www.ncbi.nlm.nih.gov/pubmed/16236739?tool=bestpractice.com
[14]Cochi SE, Kempker JA, Annangi S, et al. Mortality trends of acute respiratory distress syndrome in the United States from 1999 to 2013. Ann Am Thorac Soc. 2016 Oct;13(10):1742-51.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122485
http://www.ncbi.nlm.nih.gov/pubmed/27403914?tool=bestpractice.com
A distinção entre SDRA leve (PaO₂/FiO₂ [pressão arterial de oxigênio/fração de oxigênio inspirado] 200-300), moderada (PaO₂/FiO₂ 100-200) e grave (PaO₂/FiO₂ ≤100) foi associada a desfechos clínicos.[1]Matthay MA, Arabi Y, Arroliga AC, et al. A new global definition of acute respiratory distress syndrome. Am J Respir Crit Care Med. 2024 Jan 1;209(1):37-47.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10870872
http://www.ncbi.nlm.nih.gov/pubmed/37487152?tool=bestpractice.com
Pesquisas em andamento sugerem que existem pelo menos dois subfenótipos distintos de SDRA, embora as implicações clínicas disto estejam sob investigação.[15]Calfee CS, Delucchi K, Parsons PE, et al. Subphenotypes in acute respiratory distress syndrome: latent class analysis of data from two randomised controlled trials. Lancet Respir Med. 2014 Aug;2(8):611-20.
http://www.ncbi.nlm.nih.gov/pubmed/24853585?tool=bestpractice.com
[16]Famous KR, Delucchi K, Ware LB, et al. Acute respiratory distress syndrome subphenotypes respond differently to randomized fluid management strategy. Am J Respir Crit Care Med. 2017 Feb 1;195(3):331-8.
https://www.atsjournals.org/doi/full/10.1164/rccm.201603-0645OC
http://www.ncbi.nlm.nih.gov/pubmed/27513822?tool=bestpractice.com
[17]Calfee CS, Delucchi KL, Sinha P, et al. Acute respiratory distress syndrome subphenotypes and differential response to simvastatin: secondary analysis of a randomised controlled trial. Lancet Respir Med. 2018 Sep;6(9):691-8.
http://www.ncbi.nlm.nih.gov/pubmed/30078618?tool=bestpractice.com