Abstract :
Objective: Acute respiratory distress syndrome is a heterogeneous disease which involves both the alveoli and pulmonary vessels. Acute cor pulmonale was initially considered as a marker of severity but its impact on outcome is still controversial.
Materials and Methods: This was a prospective observational study conducted over a period of nine months in ICU of a tertiary care center in India. Out of 2028 patient admitted in ICU 64 patients with ARDS (Berlins definition) underwent transthoracic echocardiography within 3 days of admission after diagnosis.
Result: Acute cor pulmonale(ACP) was detected in 23 (36%) patients. Patients with ACP have greater the severity of disease and higher APACHE score as compared to those without ACP.Ph, PCO and P/F ratio appears to be the independent risk factor in patients for ACP in ARDS. Patients with ACP in ARDS had a higher incidence of shock and mortality(43.5%).
Conclusion: ACP is quite common in ARDS. Due to its effect on the outcome, it appears to be a major factor in deciding ventilatory strategy in patients with ARDS. Right ventricle protective approach of ventilation keeps lung and heart connected.
Keyword :
Acute respiratory distress syndrome, Acute cor pulmonale, Echocardiography, Mechanical ventilation.