Makontso Dessap et al reported the acute cor pulmonale risk score for identifying a patient with the acute respiratory distress syndrome (ARDS) who is at risk for acute cor pulmonale. This can help to identify a patient who should undergo diagnostic testing. The authors are from multiple hospitals in France.
Patient selection: ARDS with protective ventilation
Outcome: acute cor pulmonale
Parameters:
(1) cause for the ARDS
(2) driving pressure in cm H2O (difference between plateau pressure and total end-expiratory positive pressure)
(3) PaO2 to FIO2 ratio
(4) PaCO2 in mm Hg
Parameter
Finding
Points
cause for the ARDS
pneumonia
1
other
0
driving pressure
< 18 cm H2O
0
>= 18 cm H2O
1
PaCO2 to FIO2 ratio
>= 150
0
< 150 mm Hg
1
PaCO2
< 48 mm Hg
0
>= 48 mm Hg
1
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• A patient with a score >= 2 should undergo transesophageal echocardiography.
Score
Percent with Acute Cor Pulmonale
0
6%
1
10%
2
20%
3
34%
4
74%
from Figure 1, entire cohort
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