Impact of Early Goal-Directed Therapy on Mortality and Organ Dysfunction in ARDS Patients in Emergency Settings

Abstract

Background: Acute Respiratory Distress Syndrome (ARDS) is a life-threatening condition often leading to organ dysfunction and high mortality. Early Goal-Directed Therapy (EGDT) has shown promise in improving outcomes in sepsis but its role in ARDS management remains underexplored. Objective: This study aimed to evaluate the impact of Early Goal-Directed Therapy (EGDT) on mortality and organ dysfunction in ARDS patients in emergency settings at Rajshahi Medical College Hospital. Methods: A prospective study was conducted from January 2022 to June 2024, involving 102 ARDS patients. EGDT was applied as a treatment protocol, targeting predefined therapeutic goals such as optimizing fluid resuscitation, managing oxygen delivery, and maintaining acid-base balance. Mortality rates and organ dysfunction were assessed through clinical and biochemical markers. Statistical analysis included the calculation of standard deviation (SD), p-value, and comparison of survival rates. Results: Of the 102 patients, 56 (54.9%) received EGDT, while 46 (45.1%) received conventional therapy. The mortality rate in the EGDT group was 32.1%, significantly lower than the 52.2% in the conventional therapy group (p < 0.05). Organ dysfunction, measured by the Sequential Organ Failure Assessment (SOFA) score, was reduced by 38.5% in the EGDT group (mean SOFA score reduction: 2.5 ± 1.3) compared to a 17.3% reduction in the conventional therapy group (mean SOFA score reduction: 1.4 ± 0.8) (p = 0.03). Conclusion: Early Goal-Directed Therapy significantly improves survival and reduces organ dysfunction in ARDS patients in emergency settings. Further large-scale studies are needed to confirm these findings.