Acute Cardiogenic Pulmonary Edema (5)

Results
The mean age of survivors and non-survivors was 72.9 ±9.3 years and 73.8 ±10.1 years, respectively; 48.2 percent of survivors and 62.5 percent of nonsurvivors were men (p<0.05).
Table 1 shows medical history and medication use. More survivors had been hospitalized before for treatment of pulmonary edema, and more survivors had a history of congestive heart failure. The prevalence of ischemic heart disease w as the same in both groups. Nonsurvivors more frequently used calcium channel blocker medication, and there was a tendency for more frequent use of p-blocker medication among nonsurvivors (p = 0.15).
Table 2 lists patient characteristics at the onset of mechanical ventilation. Nonsurvivors had a twofold increase in the incidence of myocardial infarction compared with survivors and a threefold increase in the frequency of anterior infarction. Nonsurvivors had a lower systolic blood pressure, respiratory rate, PaC02, and serum bicarbonate level, and a higher pH than did survivors.
By analysis of receiver operator characteristic curves, a blood pressure of 130 mm Hg had the best balance of sensitivity (84.4 percent) and specificity (82.1 percent) for mortality. Figure 1 shows that patients with myocardial infarction (open circles) had a lower initial systolic pressure than those patients without myocardial infarction, 128.8 ±48.8 mm Hg compared with 167.4 ±36.8 mm Hg (p<0.001).

Table 1—Medical History and Medication Use

Table 2—Clinical Characteristics at Onset of Mechanical Ventilation

Figure 1. Systolic blood pressure at time of intubation for nonsurvivors and survivors. Open circles represent episodes associated with an acute myocardial infarction.

Category: Pulmonary disease

Tags: mechanical ventilation, myocardial infarction, pulmonary edema, systolic blood pressure