tetano
Editor, Senior Moderator
Angiology
. 2022 Jun 18;33197221105752.
doi: 10.1177/00033197221105752. Online ahead of print.
Clinical Significance of Right Ventricle Echocardiographic Patterns in Critically-Ill COVID-Related Acute Respiratory Distress Syndrome "On Behalf of Protecting the Right Ventricle Network (PRORVnet)"
Chiara Lazzeri[SUP] 1 [/SUP], Manuela Bonizzoli[SUP] 1 [/SUP], Stefano Batacchi[SUP] 1 [/SUP], Giovanni Cianchi[SUP] 1 [/SUP], Marco Chiostri[SUP] 1 [/SUP], Filippo Socci[SUP] 1 [/SUP], Adriano Peris[SUP] 1 [/SUP]
Affiliations
Abstract
We assessed whether right ventricle (RV) alterations and their development may have clinical significance in critically-ill Coronavirus Disease (COVID) patients, as detected by serial echocardiograms during Intensive Care Unit (ICU) course. This observational single center study included 98 consecutive patients with COVID-related acute respiratory distress syndrome (ARDS). Three subgroups were considered: RV Dysfunction (Dys) on admission (10/98, 10%), developed RV Dys (17/98, 17%), and no RV Dys (71/98, 73%). Overall mortality at 3 months was 46.9%. The first subgroup was characterized by the highest need for Extracorporeal Membrane Oxygenation (ECMO) support (P < .001) and a systemic inflammatory activation (as indicated by increased D-dimer), the second one by the lowest PaO2/FiO2 (P/F). At multivariate regression analysis, age and Sequential Organ Failure Assessment score were independent predictors for mortality. Different RV echo patterns were observed in critically ill patients presenting with COVID-related ARDS during ICU stay. RV Dys on admission was characterized by a high inflammatory activation while patients who developed RV Dys during ICU stay showed lowest P/F. Both these two subgroups identify patients with a severe COVID disease which in a high percentage of cases was unresponsive to standard treatment and required the use of ECMO.
Keywords: COVID; acute respiratory distress syndrome; prognosis; pulmonary hypertension; right ventricle.
. 2022 Jun 18;33197221105752.
doi: 10.1177/00033197221105752. Online ahead of print.
Clinical Significance of Right Ventricle Echocardiographic Patterns in Critically-Ill COVID-Related Acute Respiratory Distress Syndrome "On Behalf of Protecting the Right Ventricle Network (PRORVnet)"
Chiara Lazzeri[SUP] 1 [/SUP], Manuela Bonizzoli[SUP] 1 [/SUP], Stefano Batacchi[SUP] 1 [/SUP], Giovanni Cianchi[SUP] 1 [/SUP], Marco Chiostri[SUP] 1 [/SUP], Filippo Socci[SUP] 1 [/SUP], Adriano Peris[SUP] 1 [/SUP]
Affiliations
- PMID: 35722971
- DOI: 10.1177/00033197221105752
Abstract
We assessed whether right ventricle (RV) alterations and their development may have clinical significance in critically-ill Coronavirus Disease (COVID) patients, as detected by serial echocardiograms during Intensive Care Unit (ICU) course. This observational single center study included 98 consecutive patients with COVID-related acute respiratory distress syndrome (ARDS). Three subgroups were considered: RV Dysfunction (Dys) on admission (10/98, 10%), developed RV Dys (17/98, 17%), and no RV Dys (71/98, 73%). Overall mortality at 3 months was 46.9%. The first subgroup was characterized by the highest need for Extracorporeal Membrane Oxygenation (ECMO) support (P < .001) and a systemic inflammatory activation (as indicated by increased D-dimer), the second one by the lowest PaO2/FiO2 (P/F). At multivariate regression analysis, age and Sequential Organ Failure Assessment score were independent predictors for mortality. Different RV echo patterns were observed in critically ill patients presenting with COVID-related ARDS during ICU stay. RV Dys on admission was characterized by a high inflammatory activation while patients who developed RV Dys during ICU stay showed lowest P/F. Both these two subgroups identify patients with a severe COVID disease which in a high percentage of cases was unresponsive to standard treatment and required the use of ECMO.
Keywords: COVID; acute respiratory distress syndrome; prognosis; pulmonary hypertension; right ventricle.