En general, entre el 10 y el 15% de los pacientes ingresados en la unidad de cuidados intensivos cumplen los criterios para el SDRA, con una mayor incidencia entre los pacientes con ventilación mecánica.[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
La incidencia del síndrome de dificultad respiratoria aguda (SDRA) estimada es de 64 casos por cada 100,000 personas, o 190,000 casos al año en EE. UU. Esta tasa de incidencia es de 2 a 40 veces mayor que las estimaciones previas, lo que probablemente no representa una incidencia creciente, sino una subestimación 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
La incidencia del SDRA puede ser mayor en los Estados Unidos que en Europa y otros países desarrollados, aunque las evidencias sugieren que las tasas en los Estados Unidos pueden estar disminuyendo.[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
Las enfermedades críticas, el tabaquismo y el consumo de alcohol son factores predisponentes para el 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
La exposición prolongada a los contaminantes del aire ambiente también aumenta el riesgo de desarrollar 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
El sexo, la etnia y la raza no se han asociado definitivamente a la incidencia de SDRA.
La mortalidad del SDRA es de aproximadamente 30% a 50%, aunque la mortalidad en ensayos clínicos grandes parece disminuir constantemente.[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
La distinción entre síndrome de dificultad respiratoria aguda leve (PaO₂/FiO₂ 200 a 300), moderada (PaO₂/FiO₂ 100 a 200) y grave (PaO₂/FiO₂ ≤100) se ha asociado a los resultados 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
Las investigaciones en curso sugieren que existen al menos dos subfenotipos de SDRA distintos, aunque se están investigando las implicaciones clínicas de esto.[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