Effects of ambient air pollutants on ARDS incidence and outcome: a narrative review

Annals of Intensive Care

Review

Antoine Roch¹  Laëtitia Gutman¹  Laurent Papazian²  Vanessa Pauly³ 

[1] Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, Chemin Des Bourrely, 13015, Marseille, France;Faculté de Médecine, Centre d’Etudes et de Recherches Sur Les Services de Santé et qualité de vie EA 3279, Aix-Marseille Université, 13005, Marseille, France;Faculté de Médecine, Centre d’Etudes et de Recherches Sur Les Services de Santé et qualité de vie EA 3279, Aix-Marseille Université, 13005, Marseille, France;Médecine Intensive Réanimation, Centre Hospitalier de Bastia, 20600, Bastia, Corsica, France;Faculté de Médecine, Centre d’Etudes et de Recherches Sur Les Services de Santé et qualité de vie EA 3279, Aix-Marseille Université, 13005, Marseille, France;Unité d’Analyse Des Données de Santé, Assistance Publique, Hôpitaux de Marseille, 13005, Marseille, France;

关键词: Acute respiratory distress syndrome;    Environmental risk factor;    Particulate matter;    Nitrogen dioxide;    Ozone;    Air pollutant;   

DOI  :  10.1186/s13613-023-01182-1

 received in 2023-04-24, accepted in 2023-09-01,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundExposure to air pollutants promotes inflammation, cancer, and mortality in chronic diseases. Acute respiratory distress syndrome (ARDS) is a common condition among intensive care unit patients and is associated with a high mortality rate. ARDS is characterized by significant lung inflammation, which can be replicated in animal models by acute exposure to high doses of various air pollutants. Recently, several clinical studies have been conducted in different countries to investigate the role of chronic or acute air pollutant exposure in enhancing both ARDS incidence and severity.ResultsChronic exposure studies have mainly been conducted in the US and France. The results of these studies suggest that some air pollutants, notably ozone, nitrogen dioxide, and particulate matter, increase susceptibility to ARDS and associated mortality. Furthermore, their impact may differ according to the cause of ARDS. A cohort study conducted in an urbanized zone in China showed that exposure to very high levels of air pollutants in the few days preceding intensive care unit admission was associated with an increased incidence of ARDS. The effects of acute exposure are more debatable regarding ARDS incidence and severity.ConclusionThere is a likely relationship between air pollutant exposure and ARDS incidence and severity. However, further studies are required to determine which pollutants are the most involved and which patients are the most affected. Due to the prevalence of ARDS, air pollutant exposure may have a significant impact and could be a key public health issue.

【 授权许可】

CC BY   
© La Société de Réanimation de Langue Francaise = The French Society of Intensive Care (SRLF) 2023