Chen et al identified risk factors for the acute respiratory distress syndrome in patients following valvular heart surgery. These can help to identify a patient who may benefit from more aggressive management. The authors are from Chang Gung Memorial Hospital at Linkou Medical Center in Taiwan.


Patient selection: valvular heart surgery


Outcome: ARDS


Risk factors for ARDS:

(1) age (based on Table 1, page 141, will use > 60 years of age)

(2) hepatic cirrhosis

(3) massive blood transfusion (> 4 units)

(4) tricuspid valve replacement



• Massive blood transfusion raises the possibility of fluid overload.


Patients with ARDS had greater in-hospital mortality, time on ventilator, and complications.


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