@article {Pacheorespcare.02939, author = {Jose Pacheo and Heather Arnold and Lee Skrupky and Peggy Watts and Scott T. Micek and Marin H. Kollef}, title = {PREDICTORS OF OUTCOME IN 216 PATIENTS WITH ARDS TREATED WITH INHALED EPOPROSTENOL}, elocation-id = {respcare.02939}, year = {2013}, doi = {10.4187/respcare.02939}, publisher = {Respiratory Care}, abstract = {Introduction: Acute respiratory distress syndrome (ARDS) is an important cause of respiratory failure and continues to be associated with a high mortality rate. Numerous therapeutic interventions have been employed to improve patient outcomes, including inhaled epoprostenol. Methods: We examined patients with ARDS treated with epoprostenol. We compared hospital survivors with nonsurvivors to identify predictors of mortality. Results: Among the cohort (n=216) there were 80 (37\%) hospital survivors and 136 (63\%) hospital nonsurvivors. Logistic regression revealed 5 variables associated with hospital mortality: trauma as the etiology for ARDS (adjusted odds ratio [AOR], 0.09; 95\% CI, 0.04{\textendash}0.22; p=0.006), presence of both pulmonary and nonpulmonary sources of sepsis (AOR, 3.06; 95\%CI, 1.98{\textendash}4.74; p=0.010), an international standardized ratio (INR) \> 1.5 (AOR, 3.15; 95\%CI, 2.19{\textendash}4.54; p=0.002), body mass index (1-unit increments) (AOR, 0.950; 95\%CI, 0.936{\textendash}0.965; p=0.001), and an incremental change in the PaO2/FiO2 during the first 24 hours of treatment with epoprostenol (AOR, 0.991; 95\%CI, 0.988{\textendash}0.994; p=0.002). An analysis for 90-day mortality identified the same predictors with the addition of cumulative fluid balance during treatment with epoprostenol \> 4 L also being an independent predictor (AOR, 2.36; 95\%CI, 1.66{\textendash}3.37; p=0.015). Conclusions: While the use of epoprostenol in ARDS remains a therapeutic challenge, we were able to identify predictors of mortality for this important cohort of patients. These predictor variables could be employed in the design of future trials of epoprostenol in ARDS.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/early/2013/11/19/respcare.02939}, eprint = {https://rc.rcjournal.com/content/early/2013/11/19/respcare.02939.full.pdf}, journal = {Respiratory Care} }