• Daniel B Ambrus, Emelia J Benjamin, Ednan K Bajwa, Kathryn A Hibbert, and Allan J Walkey.
• Department of Internal Medicine, Section of Hospital Medicine, Umass Memorial Medical Center, 119 Belmont St, Worcester, MA, 01566; Department of Medicine, Division of General Internal Medicine, Boston University School of Medicine, 800 Massachusetts Ave, Boston, MA, USA.
• J Crit Care. 2015 Oct 1; 30 (5): 994997994-7.

PurposeOutcomes and risk factors associated with new-onset atrial fibrillation (AF) during acute respiratory distress syndrome (ARDS) are unclear. We investigated mortality and risk factors associated with new-onset AF during ARDS.Materials And MethodsWe obtained data from the ARDS Network Albuterol for Treatment of Acute Lung Injury trial, which prospectively identified new-onset AF among patients with ARDS as an adverse event. We determined Acute Physiology and Chronic Health Evaluation III-adjusted associations between new-onset AF and 90-day mortality. We also examined associations between new-onset AF and markers of inflammation (interleukin 6 and interleukin 8), myocardial injury (troponin I), autonomic activation (epinephrine), and atrial stretch (central venous pressure) as well as other clinical characteristics.Measurements And Main ResultsOf 282 patients (mean age, 51.6 years; 45% women; 77% white) enrolled in Albuterol for Treatment of Acute Lung Injury, 28 (10%) developed new-onset AF during the study. We did not identify associations between new-onset AF and baseline central venous pressure, plasma levels of troponin I, epinephrine, interleukin 6, or interleukin 8. New-onset AF during ARDS was associated with increased 90-day mortality (new-onset AF, 43% vs no new-onset AF, 19%; Acute Physiology and Chronic Health Evaluation-adjusted odds ratio, 3.09 [95% confidence interval, 1.24-7.72]; P = .02).ConclusionNew-onset AF during ARDS is associated with increased mortality; however, its mechanisms require further study.Copyright © 2015 Elsevier Inc. All rights reserved.

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