Value of pulmonary artery compliance in acute respiratory distress syndrome

  Objective  To detect pulmonary artery compliance and right heart function in patients with acute respiratory distress syndrome (ARDS), and to explore the relationships between pulmonary artery compliance and right heart function as well as short-term prognosis of ARDS.

  Methods  A total of 135 ARDS patients (observation group) and 46 healthy subjects (control group) were selected as subjects. According to the prognosis of 30 days, they were divided into death group (n=89) and survival group (n=46). Pulmonary artery systolic pressure (PASP) was measured, atrial septal defect area index (ASD-AI) and pulmonary arterial compliance index (PACI) were calculated, and PACI was used as indicators to evaluate the compliance of pulmonary artery; stroke volume (RVSV) and other indicators of right heart function were measured; the correlation between PACI and right heart function was analyzed; the levels of PASP, ASD-AI and PACI in patients with different prognosis were compared; the value of PACI in predicting short-term prognosis ARDS of patients was analyzed.

  Results  PASP, ASD-AI, right ventricular end-diastolic volume (RVEDV) and arterial partial pressure of carbon dioxidep_a(CO₂) in the observation group were significantly higher, and PACI, right ventricular ejection fraction (RVEF), right ventricular end-systolic volume (RVESV), mean arterial pressure (MAP), arterial partial pressure of oxygenp_a(O₂) and oxygenation indexp_a(O₂) to FiO₂ were significantly lower than those in the control group (P < 0.05). In ARDS patients, PACI was positively correlated with RVEF, RVESV and p_a(O₂)/FiO₂ (P < 0.05), and negatively correlated with RVEDV (P < 0.05). PASP and ASD-AI levels in the death group were significantly higher, PACI and p_a(O₂)/FiO₂ levels were significantly lower than those in the survival group (P < 0.05). Receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of PACI for the short-term prognosis of ARDS was 0.844, the sensitivity was 70.8%, and the specificity was 80.4%.

  Conclusion  In ARDS patients, pulmonary artery compliance and right heart function both decrease. PACI has a certain correlation with right heart function, and PACI can play a role in predicting the short-term prognosis of ARDS patients.