Persistent Right Ventricle Dilatation in SARS-CoV-2-Related Acute Respiratory Distress Syndrome on Extracorporeal Membrane Oxygenation Support.
J Cardiothorac Vasc Anesth
; 36(7): 1956-1961, 2022 07.
Artículo
en Inglés
| MEDLINE | ID: covidwho-1364615
ABSTRACT
OBJECTIVES:
Venovenous extracorporeal membrane oxygenation (ECMO) support may be considered in experienced centers for patients with acute respiratory distress syndrome (ARDS) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection refractory to conventional treatment. In ECMO patients, echocardiography has emerged as a clinical tool for implantation and clinical management; but to date, little data are available on COVID-related ARDS patients requiring ECMO. The authors assessed the incidence of right ventricular dilatation and dysfunction (RvDys) in patients with COVID-related ARDS requiring ECMO.DESIGN:
Single-center investigation.SETTING:
Intensive care unit (ICU).PARTICIPANTS:
A total of 35 patients with COVID-related ARDS requiring ECMO, consecutively admitted to the ICU (March 1, 2020, to February 28, 2021).INTERVENTIONS:
Serial echocardiographic examinations. RvDys was defined as RV end-diastolic area/LV end-diastolic area >0.6 and tricuspid annular plane excursion <15 mm. MEASUREMENTS AND MAINRESULTS:
The incidence of RvDys was 15/35 (42%). RvDys patients underwent ECMO support after a longer period of mechanical ventilation (p = 0.006) and exhibited a higher mortality rate (p = 0.024) than those without RvDys. In nonsurvivors, RvDys was observed in all patients (n = nine) who died with unfavorable progression of COVID-related ARDS. In survivors, weaned from ECMO, a significant reduction in systolic pulmonary arterial pressures was detectable.CONCLUSIONS:
According to the authors' data, in COVID-related ARDS requiring ECMO support, RvDys is common, associated with increased ICU mortality. Overall, the data underscored the clinical role of echocardiography in COVID-related ARDS supported by venovenous ECMO, because serial echocardiographic assessments (especially focused on RV changes) are able to reflect pulmonary COVID disease severity.Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Síndrome de Dificultad Respiratoria
/
Oxigenación por Membrana Extracorpórea
/
Disfunción Ventricular Derecha
/
COVID-19
/
Cardiopatías Congénitas
Tipo de estudio:
Estudio observacional
/
Estudio pronóstico
Tópicos:
Covid persistente
Límite:
Humanos
Idioma:
Inglés
Revista:
J Cardiothorac Vasc Anesth
Asunto de la revista:
Anestesiología
/
Cardiología
Año:
2022
Tipo del documento:
Artículo
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