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Is hypoxemia explained by intracardiac or intrapulmonary shunt in COVID-19-related acute respiratory distress syndrome?
Masi, Paul; Bagate, François; d'Humières, Thomas; Al-Assaad, Lara; Abou Chakra, Laure; Derumeaux, Genevieve; Mekontso Dessap, Armand.
  • Masi P; Service de Médecine Intensive Réanimation, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France. paul.masi@aphp.fr.
  • Bagate F; Groupe de recherche clinique CARMAS, Faculté de Santé, Université Paris Est Créteil, 94010, Créteil, France. paul.masi@aphp.fr.
  • d'Humières T; Service de Médecine Intensive Réanimation, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France.
  • Al-Assaad L; Groupe de recherche clinique CARMAS, Faculté de Santé, Université Paris Est Créteil, 94010, Créteil, France.
  • Abou Chakra L; Service de Physiologie, AP-HP, Hôpitaux Universitaires Henri Mondor, 94010, Créteil, France.
  • Derumeaux G; INSERM U955, Université Paris-Est, Créteil, France.
  • Mekontso Dessap A; Service de Physiologie, AP-HP, Hôpitaux Universitaires Henri Mondor, 94010, Créteil, France.
Ann Intensive Care ; 10(1): 108, 2020 Aug 06.
Article in English | MEDLINE | ID: covidwho-696210
ABSTRACT
Hypoxemia is the main feature of COVID-19-related acute respiratory distress syndrome (C-ARDS), but its underlying mechanisms are debated, especially in patients with low respiratory system elastance (Ers). We assessed 60 critically ill patients hospitalized in our intensive care unit for C-ARDS. We used contrast transthoracic echocardiography to assess patent foramen ovale (PFO) shunt and transpulmonary bubble transit (TPBT). The median Ers was 32 cmH2O/L. PFO shunt was detected in six (10%) patients and TPBT in 12 (20%) patients. PFO shunt and TPBT were similar in patients with higher or lower Ers. In conclusion, PFO and TPBT do not seem to be the main drivers of hypoxemia in C-ARDS, especially in patients with lower Ers.

Full text: Available Collection: International databases Database: MEDLINE Language: English Journal: Ann Intensive Care Year: 2020 Document Type: Article Affiliation country: S13613-020-00726-z

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Full text: Available Collection: International databases Database: MEDLINE Language: English Journal: Ann Intensive Care Year: 2020 Document Type: Article Affiliation country: S13613-020-00726-z