Acute hypoxemic respiratory failure in a university student of african descent following water pipe (shisha) smoking: a case report and literature review

with ARDS in a study site during 2015-2017. Data on patients’ general and clinical conditions, radiographic findings, ventilator settings, gas exchange, and treatment methods were collected and compared between survivors and non-survivors. Risk factors for mortality were assessed using a logistic regression analysis. Results. Among 126 eligible patients with ARDS, we observed high mortality (57.1%). Of the total patients, 91.3% were transferred from local hospitals with a diagnosis of severe pneumonia and then diagnosed with ARDS at the central hospital. At the time of admission, 53.2% of patients had severe ARDS, 37.3% had moderate ARDS, and 9.5% had mild ARDS. The mean (standard deviation) sequential organ failure assessment (SOFA) score was 9.5 (3.4) in non-survivors and 7.4 (3.4) in survivors (P=0.002). Although there was no significant difference in PaO2/ FiO2 on admission between non-survivors and survivors, that on day 3 after admission was significantly different (P=0.002). A logistic regression revealed that PaO2/FiO2 on day 3 [odds ratio (OR), 1.010; 95% confidence interval (CI), 1.003-1.017], length of stay in a local hospital before admission to the central hospital (OR, 1.122; 95% CI, 1.042-1.210) due to stable condition, and SOFA score on Day 1 (OR, 0.842; 95% CI, 0.708-1.002) were independent factors in patients’ survival. Conclusions. Patients with ARDS admitted the central hospital had severe illness and high mortality. Most patients were transferred from local hospitals. Improvements in human, medical, and sociological resources in local will contribute for reducing the mortality of ARDS in Vietnam.