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Title of Journal: Intensive Care Med

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Abbravation: Intensive Care Medicine

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Springer-Verlag

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DOI

10.1002/tera.1420430603

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1432-1238

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High values of the pulmonary artery wedge pressure

Authors: Niall D Ferguson Maureen O Meade David C Hallett Thomas E Stewart
Publish Date: 2014/04/11
Volume: 28, Issue: 8, Pages: 1073-1077
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Abstract

Objective To determine the incidence and severity of pulmonary artery wedge pressure PAWP elevation in patients with ALI/ARDS In addition to examine the effects of clinical variables on the presence of a high PAWP 18 mmHg and the effect of an elevated PAWP on mortalityDesign and patients Post hoc analysis of 120 patients with or at high risk of ARDS enrolled in a randomized controlled trial of pressure and volumelimited ventilation Patients with or at high risk of congestive heart failure were excluded from the original studyMeasurements and results Pulmonary artery catheters were inserted at the discretion of the attending physician and PAWP was collected every 8 h when present Of 120 subjects 71 59 had a pulmonary artery catheter 44 at randomization 27 later The mean maximum PAWP reading among patients was 225 mmHg 95 CI 212–238 and mean median was 166 mmHg 95 CI 156–175 Patients who met standard criteria for ARDS were more likely to develop a high PAWP In a multivariate stepwise logistic regression model a persistently elevated PAWP median 18 mmHg was a strong predictor of mortality after correction for baseline differences OR estimate 682 95 CI 166–3781

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