| Title |
Acute cor pulmonale during protective ventilation for acute respiratory distress syndrome: prevalence, predictors, and clinical impact
|
|---|---|
| Published in |
Intensive Care Medicine, December 2015
|
| DOI | 10.1007/s00134-015-4141-2 |
| Pubmed ID | |
| Authors |
Armand Mekontso Dessap, Florence Boissier, Cyril Charron, Emmanuelle Bégot, Xavier Repessé, Annick Legras, Christian Brun-Buisson, Philippe Vignon, Antoine Vieillard-Baron |
| Abstract |
Increased right ventricle (RV) afterload during acute respiratory distress syndrome (ARDS) may induce acute cor pulmonale (ACP). To determine the prevalence and prognosis of ACP and build a clinical risk score for the early detection of ACP. This was a prospective study in which 752 patients with moderate-to-severe ARDS receiving protective ventilation were assessed using transesophageal echocardiography in 11 intensive care units. The study cohort was randomly split in a derivation (n = 502) and a validation (n = 250) cohort. ACP was defined as septal dyskinesia with a dilated RV [end-diastolic RV/left ventricle (LV) area ratio >0.6 (≥1 for severe dilatation)]. ACP was found in 164 of the 752 patients (prevalence of 22 %; 95 % confidence interval 19-25 %). In the derivation cohort, the ACP risk score included four variables [pneumonia as a cause of ARDS, driving pressure ≥18 cm H2O, arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2) ratio <150 mmHg, and arterial carbon dioxide partial pressure ≥48 mmHg]. The ACP risk score had a reasonable discrimination and a good calibration. Hospital mortality did not differ between patients with or without ACP, but it was significantly higher in patients with severe ACP than in the other patients [31/54 (57 %) vs. 291/698 (42 %); p = 0.03]. Independent risk factors for hospital mortality included severe ACP along with male gender, age, SAPS II, shock, PaO2/FiO2 ratio, respiratory rate, and driving pressure, while prone position was protective. We report a 22 % prevalence of ACP and a poor outcome of severe ACP. We propose a simple clinical risk score for early identification of ACP that could trigger specific therapeutic strategies to reduce RV afterload. |
X Demographics
The data shown below were collected from the profiles of 14 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 3 | 21% |
| Mexico | 2 | 14% |
| United States | 2 | 14% |
| Unknown | 7 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 11 | 79% |
| Scientists | 2 | 14% |
| Practitioners (doctors, other healthcare professionals) | 1 | 7% |
Mendeley readers
The data shown below were compiled from readership statistics for 323 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | <1% |
| Italy | 1 | <1% |
| Unknown | 321 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 43 | 13% |
| Other | 38 | 12% |
| Student > Master | 25 | 8% |
| Student > Postgraduate | 24 | 7% |
| Student > Bachelor | 22 | 7% |
| Other | 72 | 22% |
| Unknown | 99 | 31% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 181 | 56% |
| Nursing and Health Professions | 12 | 4% |
| Biochemistry, Genetics and Molecular Biology | 5 | 2% |
| Engineering | 4 | 1% |
| Social Sciences | 3 | <1% |
| Other | 18 | 6% |
| Unknown | 100 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 16. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 March 2022.
All research outputs
#2,032,187
of 23,577,654 outputs
Outputs from Intensive Care Medicine
#1,564
of 5,104 outputs
Outputs of similar age
#35,608
of 392,345 outputs
Outputs of similar age from Intensive Care Medicine
#6
of 43 outputs
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