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Title of Journal: Intensive Care Med

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Abbravation: Intensive Care Medicine

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Springer Berlin Heidelberg

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DOI

10.1002/ajmg.1320460304

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ISSN

1432-1238

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Acute cor pulmonale in ARDS

Authors: A VieillardBaron L C Price M A Matthay
Publish Date: 2013/08/02
Volume: 39, Issue: 10, Pages: 1836-1838
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Abstract

In 1977 Zapol and colleagues 1 reported that the pulmonary circulation was injured in patients with ARDS leading to elevated pulmonary vascular resistance and pulmonary hypertension The investigators suggested that the pathogenesis was related to competition between alveolar distending pressure and blood flow in these patients who were ventilated with high airway pressure 2 as proposed by West et al 3 Pulmonary vascular remodeling also occurs with muscularization of normally nonmuscularized arteries Subsequently using transesophageal echocardiography TEE 24 years later VieillardBaron et al 4 reported an incidence of acute cor pulmonale ACP of 25  during the first 3 days in 75 ARDS patients treated with lung protective ventilation A few years later the same group reported a much higher incidence of 50  in more severe patients all exhibiting a PaO2/FiO2 100 mmHg 5 The same group studied 352 patients and found that the incidence of ACP was related to

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