Please use this identifier to cite or link to this item: https://doi.org/10.1186/s13613-017-0343-9
Title: Frequency and prognostic impact of basic critical care echocardiography abnormalities in patients with acute respiratory distress syndrome
Authors: See, K.C 
Ng, J 
Siow, W.T 
Ong, V
Phua, J 
Keywords: adult
adult respiratory distress syndrome
APACHE
Article
basic critical care echocardiography
comparative study
controlled study
cor pulmonale
disease severity
echocardiography
female
heart ejection fraction
heart left ventricle ejection fraction
hospital mortality
human
intensive care
intensive care unit
length of stay
major clinical study
male
middle aged
observational study
priority journal
prospective study
transthoracic echocardiography
Issue Date: 2017
Citation: See, K.C, Ng, J, Siow, W.T, Ong, V, Phua, J (2017). Frequency and prognostic impact of basic critical care echocardiography abnormalities in patients with acute respiratory distress syndrome. Annals of Intensive Care 7 (1) : 120. ScholarBank@NUS Repository. https://doi.org/10.1186/s13613-017-0343-9
Abstract: Background: Among intensive care unit (ICU) patients with acute respiratory distress syndrome (ARDS), apart from acute cor pulmonale (ACP), the frequency and prognostic impact of basic critical care echocardiography (BCCE) abnormalities are not well defined. Methods: Observational study of patients with ARDS, admitted from September 2012 to May 2014, who underwent BCCE within 48 h of admission to a 20-bed medical ICU. We examined the association of two major BCCE-detected abnormalities (left ventricular ejection fraction < 40% and severe ACP) with ICU/hospital mortality and ICU/hospital length of stay. Multivariable models adjusted for age and illness severity. Results: Of 234 patients with ARDS (age 62.3 ± 14.3 years; 88/37.6% female; APACHE II 26.8 ± 8.3; 26.5% ICU mortality; 32.1% hospital mortality), 94 (40.2%) had at least one major BCCE-detected abnormality. The more common major BCCE abnormality found was severe ACP (28.2%), followed by left ventricular ejection fraction < 40% (16.2%). On multivariate analysis, only severe ACP remained significantly associated with ICU/hospital mortality. Hospital mortality for mild, moderate and severe ARDS was 17.0, 27.9 and 50.0%, respectively (without severe ACP), and was 29.2, 48.3 and 53.8%, respectively (with severe ACP). Conclusions: BCCE abnormalities were common, but only severe ACP had prognostic significance in ARDS, identifying patients who are at increased risk of ICU and hospital mortality. The presence of severe ACP appears to upstage ARDS severity by one level. © 2017, The Author(s).
Source Title: Annals of Intensive Care
URI: https://scholarbank.nus.edu.sg/handle/10635/176067
ISSN: 2110-5820
DOI: 10.1186/s13613-017-0343-9
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