Critical Care |

Effects of ACE Inhibitors/ARBs on ARDS Outcomes FREE TO VIEW

ankur mishra, MBBS
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University of North Dakota, Fargo, ND

Chest. 2015;148(4_MeetingAbstracts):183A. doi:10.1378/chest.2243121
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Clinical studies have found that prior use of ACE inhibitors was associated with a decreased risk of developing pneumonia in Asians. In animal models ACE inhibitors improve endothelial function in sepsis and prevent development of pulmonary arterial hypertension and ARDS. In this study we sought to determine if ACEIs/ARBs have a role in decreasing mortality in ALI/ARDS population.

METHODS: We performed a retrospective cohort evaluation of the association between ACEIs/ARBs and mortality differences in the ALI/ARDS population. 260 pts were identified using the ICD code 518.82. 48 were identified with true ARDS/ALI. 10 were on ACEi/ARBs and 38 were not. Chi square tests and t tests were used for data analysis.

RESULTS: Of the initial group of 260 patients only 48 were found to have true ALI/ARDS. Of these 10 were on ACEIs/ARBs and 38 were not. Both the groups were evenly matched for age, statin use, steroid use, smoking status, other co-morbidities like DM, COPD, sepsis, shock. The degree of severity of ARDS was also similar in both the groups. The 30 day mortality was very similar in the 2 groups, at 40% in the ACEIs/ARBs group and 39% in the non ACEIs/ARBs group ( p value at 1.00). There was also no difference found in the length of intubation in days (13.9 vs 11.7, p-value of 0.50), ICU length of stay (15.1 vs 15.8, p-value of 0.86) and 1 year mortality (60% vs 55%, p-value of 1.00).

CONCLUSIONS: In patients with ARDS, ACEIs/ARBs was not associated with a statistically significant reduction in mortality either short term or long term.

CLINICAL IMPLICATIONS: These results do not support the use of ACEIs/ARBs routinely in ARDS population with the intent of reducing mortality. Larger/Prospective studies are needed to further define the role of ACEi/ARBs in ARDS if any.

DISCLOSURE: The following authors have nothing to disclose: ankur mishra

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