Background: Assessment of disease severity in patients with acute respiratory distress syndrome (ARDS) admitted to the intensive care unit is crucial for selecting appropriate treatment strategies and predicting clinical outcomes. Although the APACHE II scoring system is widely used, it does not adequately reflect key ARDS-specific parameters such as hypoxemia and the degree of lung injury.

Methods: This study included 89 patients with confirmed ARDS treated in the intensive care unit between 2021 and 2023. Clinical, laboratory and instrumental data were analyzed, including oxygenation index (PaO2/FiO2), lung injury index (LII), inflammatory markers (CRP, procalcitonin, IL-6), and vital parameters. Based on the limitations of APACHE II, a modified scoring system-APACHE V-was developed by excluding less informative parameters and incorporating more relevant indicators of respiratory failure and systemic inflammation.

Results: The proposed APACHE V scale, consisting of 16 parameters, demonstrated improved sensitivity in assessing the severity of ARDS compared to conventional methods. Parameters such as oxygenation index and lung injury index provided a more objective evaluation of respiratory dysfunction, while inflammatory markers, particularly procalcitonin and CRP, reflected the intensity of the systemic inflammatory response. Dynamic monitoring of these indicators showed significant differences between patient groups over time.

Conclusion: The APACHE V scoring system offers a more comprehensive and clinically relevant tool for assessing disease severity in ARDS patients. Its use may improve the accuracy of prognosis, optimize treatment strategies, and enhance clinical decision-making in intensive care practice.