Lung protective ventilation and hospital survival of cardiac intensive care patients

Med Klin Intensivmed Notfmed. 2016 Sep;111(6):508-13. doi: 10.1007/s00063-015-0105-0. Epub 2015 Oct 27.

Abstract

Objective: To detect connections between parameters of ventilation and outcomes of cardiac intensive care patients.

Design and setting: Noninterventional study. Between 05/11 and 05/12 all patients with acute heart failure and post cardiopulmonary resuscitation were registered. Lung protective ventilation was defined as peak inspiratory pressure (PIP) < 30 mmHg and tidal volume (Vt) < = 6 ml/kg.

Results: In total, 129 patients were included in the study, 68.2 % male, age 67.9 ± 13.4 years, weight 71.4 ± 37.2 kg, predictive body weight 66.9 ± 8.8 kg, mortality 47.3 %. Lung protective ventilated patients at day 1: 17.3 % with a significant difference between surviving and nonsurviving patients (24.1 % vs. 9.6 %; p < 0.05). Logistic regression models showed a strong connection between PIP and survival (odds ratio 1.13; p < 0.05). Vt showed no significant influence on survival.

Conclusion: Our data recommends a strict observance of a low PIP for cardiac intensive care patients, whereas Vt seems to be of secondary importance.

Keywords: Acute heart failure; Cardiopulmonary resuscitation; Lung protection; Lung protective ventilation; Peak inspiratory pressure; Tidal volume.

MeSH terms

  • Aged
  • Critical Care*
  • Female
  • Humans
  • Lung
  • Male
  • Middle Aged
  • Positive-Pressure Respiration
  • Respiration, Artificial*
  • Respiratory Distress Syndrome*
  • Tidal Volume*