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Although most guidelines on the management of ARDS recommend avoiding the use of pulmonary vasodilators due to their potential deleterious effects, some authors advocate their use. The objective of this study was to analyze the clinical characteristics and outcomes of patients with ARDS receiving or not receiving pulmonary vasodilators.

Methods
=======

This is a retrospective observational study carried out in a 34-bed ICU in a university hospital. Demographics, clinical, and laboratory data from patients with ARDS admitted to the ICU between January 2007 and December 2011 were analyzed. Patients were divided into two groups: those receiving (PV group) and those not receiving (NV group) pulmonary vasodilators. Statistical analyses used Fisher’s test and the two-tailed Student’s *t*-test. The level of significance was 5%.

Results
=======

A total of 182 ARDS patients were admitted to the ICU, with a mean APACHE II score of 21 ± 8. The PV group had more older patients and higher APACHE II and SOFA scores than the NV group. Patients in the PV group had higher positive fluid balance, and had received more mechanical ventilation time and fluid infusion. There was a higher rate of lung-protective ventilation and a higher positive end-expiratory pressure (PEEP) and plateau pressure in the PV group. There was no difference in respiratory parameters between the groups. No differences were found between the groups in rates of influenza vaccination and implementation of different measures. All patients received standard management in both groups. Hospital and 28-day mortality rates did not differ between the groups (54% for PV group vs. 45% for NV group; *P*= 0.28). The ICU length of stay and ICU and hospital LOS did not differ between the groups.

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