Published online Mar 9, 2021. doi: 10.5492/wjccm.v10.i2.35
Peer-review started: December 6, 2020
First decision: December 31, 2020
Revised: January 1, 2020
Accepted: January 28, 2021
Article in press: January 28, 2021
Published online: March 9, 2021
Core Tip: Acute respiratory distress syndrome (ARDS)-related acute cor pulmonale (ACP) is associated with adverse hemodynamic and survival outcomes. It is an echocardiographic diagnosis marked by combined right ventricular dilatation and septal dyskinesia. Checking for ARDS-related ACP should be done in patients with ≥ 2 of 4 risk factors: Pneumonia, arterial partial pressure of oxygen-to-inspired oxygen fraction ratio < 150 mmHg, arterial partial pressure of carbon dioxide ≥ 48 mmHg, and driving pressure ≥ 18 cmH2O. Treatments include ventilator adjustment (aiming for arterial partial pressure of carbon dioxide < 60 mmHg, plateau pressure < 27 cmH2O, driving pressure < 17 cmH2O), prone positioning, fluid balance optimization and pharmacotherapy.