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• W2017920913 abstract "The survival and ICU length of stay of 40 ARDS patients admitted to the ICU were analyzed to determine if a management strategy of lowering the pulmonary capillary wedge pressure (Ppw) was associated with an increased survival or a decreased ICU length of stay. ARDS was defined as three or four quadrant alveolar filling roentgenographically, a PaO2 <80 mm Hg with an FOo2 >.5 and a Ppw <18 mm Hg. Patients were divided into two groups: group 1 included all patients in whom there was a reduction of Ppw by at least 25 percent, and group 2 included patients in whom there was no, or less than a 25 percent reduction in Ppw. Survival was statistically different between the groups with 12 of 16 group 1 patients and seven of 24 group 2 patients surviving to hospital discharge. This difference remained statistically significant after stratifying patients by age and the APACHE II severity of illness index. We conclude that this retrospective analysis supports the notion that treatment of low pressure pulmonary edema with reduction of Ppw is associated with an increased survival. The survival and ICU length of stay of 40 ARDS patients admitted to the ICU were analyzed to determine if a management strategy of lowering the pulmonary capillary wedge pressure (Ppw) was associated with an increased survival or a decreased ICU length of stay. ARDS was defined as three or four quadrant alveolar filling roentgenographically, a PaO2 <80 mm Hg with an FOo2 >.5 and a Ppw <18 mm Hg. Patients were divided into two groups: group 1 included all patients in whom there was a reduction of Ppw by at least 25 percent, and group 2 included patients in whom there was no, or less than a 25 percent reduction in Ppw. Survival was statistically different between the groups with 12 of 16 group 1 patients and seven of 24 group 2 patients surviving to hospital discharge. This difference remained statistically significant after stratifying patients by age and the APACHE II severity of illness index. We conclude that this retrospective analysis supports the notion that treatment of low pressure pulmonary edema with reduction of Ppw is associated with an increased survival. ARDS: The Therapeutic DilemmaCHESTVol. 97Issue 5PreviewThe adult respiratory distress syndrome (ARDS) has numerous clinical predispositions, but the most common is infection with aerobic, Gram-negative rods. The syndrome can result after direct bacterial infection of the lungs or more frequently after abdominal or other distant infection, presumably due to intravascular spread of bacteria or toxic bacterial products. Manifesting itself as overwhelming acute respiratory failure with an exudative pulmonary edema, ARDS usually occurs in the absence of significant cardiac dysfunction. Full-Text PDF" @default.
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• W2017920913 title "Improved Survival in ARDS Patients Associated with a Reduction in Pulmonary Capillary Wedge Pressure" @default.
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• W2017920913 doi "https://doi.org/10.1378/chest.97.5.1176" @default.
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