Patterns of cardiovascular drug therapy among mechanically ventilated adults

Introduction. Over the last 5 years, there is increasing interest in non-pulmonary determinants of weaning from mechanical ventilatory support (MVS), especially left ventricular (LV) dysfunction. Methods. This study explored patterns in cardiovascular drug therapy, comparing subjects who weaned from MVS with those who remain ventilator dependent. Data were extracted from the bedside computerized medical record. Results. Fifty-eight critically ill adults (29M, 29F), 55 Caucasians and 3 African-Americans, ranging in age from 21 to 89 years (mean 64.1, median 65.5 years), requiring MVS for 1 to 49 days. Subjects who waned more often received ACE inhibitors, calcium channel blockers, beta blockers, vasodilators and/or nitrates than those who failed to wean. Diuretics and digoxin were not differentially associated with successful weaning to spontaneous breathing. Conclusions. The findings are consistent with recent reports of LV dysfunction and of occult myocardial injury among adults requiring MVS. It may be advantageous to explore the treatment of heart disease to assist in ventilator weaning.