Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2021
Right Ventricle Dilation Detected on Point-of-Care Ultrasound Is a Predictor of Poor Outcomes in Critically Ill Patients With COVID-19.
СтатьяНазвание и аннотация: Перевод в очереди
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Belligund Pooja, Lee David, Balasubramaniam Mehrala, Khanijao Suchit, Damania Dushyant, Vallumsetla Nishant, Sajawal Qasim, Perez-Gandara Brais, Perez-Perez Jessica, Shalom Isaac, Dubey Gangacharan, Sanghavi Sarah, Lu Chen, Mitre Cristina, Zein Joe, Al-Ajam Mohammad
Аннотация
BACKGROUND: During the COVID-19 pandemic, the need for judicious use of diagnostic tests and to limit personnel exposure has led to increased use and dependence on point-of-care ultrasound (POCUS) examinations. We reviewed POCUS findings in patients admitted to the intensive care unit (ICU) for acute respiratory failure with COVID-19 and correlated the findings to severity of illness and 30-day outcomes.
METHODS: Patients admitted to the ICU in March and April 2020 were reviewed for inclusion (acute hypoxemic respiratory failure secondary to COVID-19 pneumonia; documentation of POCUS findings).
RESULTS: Forty-three patients met inclusion criteria. B lines and pleural thickening were associated with a lower PaO2/FiO2 by 71 (P = .005; adjusted R 2 = 0.24). Right ventricle (RV) dilation was more common in patients with 30-day mortality (P = .02) and was a predictor of mortality when adjusted for hypertension, diabetes mellitus, and age (odds ratio, 12.0; P = .048). All patients with RV dilation had bilateral B lines with pleural irregularities.
CONCLUSIONS: Although lung ultrasound abnormalities are prevalent in patients with severe disease, RV involvement seems to be predictive of outcomes. Further studies are needed to discern the etiology and pathophysiology of RV dilation in COVID-19.
METHODS: Patients admitted to the ICU in March and April 2020 were reviewed for inclusion (acute hypoxemic respiratory failure secondary to COVID-19 pneumonia; documentation of POCUS findings).
RESULTS: Forty-three patients met inclusion criteria. B lines and pleural thickening were associated with a lower PaO2/FiO2 by 71 (P = .005; adjusted R 2 = 0.24). Right ventricle (RV) dilation was more common in patients with 30-day mortality (P = .02) and was a predictor of mortality when adjusted for hypertension, diabetes mellitus, and age (odds ratio, 12.0; P = .048). All patients with RV dilation had bilateral B lines with pleural irregularities.
CONCLUSIONS: Although lung ultrasound abnormalities are prevalent in patients with severe disease, RV involvement seems to be predictive of outcomes. Further studies are needed to discern the etiology and pathophysiology of RV dilation in COVID-19.