Study design
This study involved the retrospective assessment of data from 522 consecutive patients who underwent ATAAD at our Hospital from September 2017 to June 2021, including patients who were diagnosed at our hospital and those who were transferred to our center from other hospitals. All patients were diagnosed using transthoracic echocardiography (TTE) and computed tomography angiography. The following exclusion criteria were applied: history of lung diseases (chronic obstructive pulmonary disease, asthma, lung tumor, respiratory failure); New York class III or IV; preoperative liver and kidney insufficiency; severe neurological and psychiatric disease; history of nonsteroidal anti-inflammatory drug and hormone therapy; and died within 48 h post-surgery. Overall, 479 patients were included after the exclusion criteria were applied. Based on the Berlin definition,4 ALI severity was classified as follows: mild ALI (200 mmHg < oxygen index [OI] ≤ 300 mmHg), moderate ALI (100 mmHg < OI ≤ 200 mmHg), and severe ALI (OI ≤ 100 mmHg). Patients were placed in postoperative severe and non-severe ALI groups according to whether severe ALI occurred within a 72-h postoperative period. Ethical approval for this study (Identifier: 2020-298H-1) was provided by the Guangdong Provincial People’s Hospital’s Clinical Research Ethics Committee on July 8, 2021. Due to the retrospective retrieval of the patients data, the informed consent was waived.