TY - JOUR
T1 - Cardiac function in critically ill patients with severe COVID
T2 - A prospective cross-sectional study in mechanically ventilated patients
AU - Valenzuela, Emilio Daniel
AU - Mercado, Pablo
AU - Pairumani, Ronald
AU - Medel, Juan Nicolás
AU - Petruska, Edward
AU - Ugalde, Diego
AU - Morales, Felipe
AU - Eisen, Daniela
AU - Araya, Carla
AU - Montoya, Jorge
AU - Gonzalez, Alejandra
AU - Rovegno, Maximiliano
AU - Ramirez, Javier
AU - Aguilera, Javiera
AU - Hernández, Glenn
AU - Bruhn, Alejandro
AU - Slama, Michel
AU - Bakker, Jan
N1 - Publisher Copyright: © 2022 Elsevier Inc.
PY - 2022/12
Y1 - 2022/12
N2 - Purpose: To evaluate cardiac function in mechanically ventilated patients with COVID-19. Materials and methods: Prospective, cross-sectional multicenter study in four university-affiliated hospitals in Chile. All consecutive patients with COVID-19 ARDS requiring mechanical ventilation admitted between April and July 2020 were included. We performed systematic transthoracic echocardiography assessing right and left ventricular function within 24 h of intubation. Results: 140 patients aged 57 ± 11, 29% female were included. Cardiac output was 5.1 L/min [IQR 4.5–6.2] and 86% of the patients required norepinephrine. ICU mortality was 29% (40 patients). Fifty-four patients (39%) exhibited right ventricle dilation out of whom 20 patients (14%) exhibited acute cor pulmonale (ACP). Eight out of the twenty patients with ACP exhibited pulmonary embolism (40%). Thirteen patients (9%) exhibited left ventricular systolic dysfunction (ejection fraction <45%). In the multivariate analysis acute cor pulmonale and PaO2/FiO2 ratio were independent predictors of ICU mortality. Conclusions: Right ventricular dilation is highly prevalent in mechanically ventilated patients with COVID-19 ARDS. Acute cor pulmonale was associated with reduced pulmonary function and, in only 40% of patients, with co-existing pulmonary embolism. Acute cor pulmonale is an independent risk factor for ICU mortality.
AB - Purpose: To evaluate cardiac function in mechanically ventilated patients with COVID-19. Materials and methods: Prospective, cross-sectional multicenter study in four university-affiliated hospitals in Chile. All consecutive patients with COVID-19 ARDS requiring mechanical ventilation admitted between April and July 2020 were included. We performed systematic transthoracic echocardiography assessing right and left ventricular function within 24 h of intubation. Results: 140 patients aged 57 ± 11, 29% female were included. Cardiac output was 5.1 L/min [IQR 4.5–6.2] and 86% of the patients required norepinephrine. ICU mortality was 29% (40 patients). Fifty-four patients (39%) exhibited right ventricle dilation out of whom 20 patients (14%) exhibited acute cor pulmonale (ACP). Eight out of the twenty patients with ACP exhibited pulmonary embolism (40%). Thirteen patients (9%) exhibited left ventricular systolic dysfunction (ejection fraction <45%). In the multivariate analysis acute cor pulmonale and PaO2/FiO2 ratio were independent predictors of ICU mortality. Conclusions: Right ventricular dilation is highly prevalent in mechanically ventilated patients with COVID-19 ARDS. Acute cor pulmonale was associated with reduced pulmonary function and, in only 40% of patients, with co-existing pulmonary embolism. Acute cor pulmonale is an independent risk factor for ICU mortality.
UR - http://www.scopus.com/inward/record.url?scp=85139724863&partnerID=8YFLogxK
U2 - 10.1016/j.jcrc.2022.154166
DO - 10.1016/j.jcrc.2022.154166
M3 - Article
C2 - 36244256
AN - SCOPUS:85139724863
SN - 0883-9441
VL - 72
JO - Journal of Critical Care
JF - Journal of Critical Care
M1 - 154166
ER -