Journal of critical care · 2025
Different microcirculatory patterns in patients with COVID-19 and non-COVID-19 ARDS: A multicenter cross-sectional study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Kanoore Edul Vanina Siham, Caminos Eguillor Juan Francisco, Romano Juan, Mugno Matías, Ferrara Gonzalo, Estenssoro Elisa, Páez Siles Daniel Shiovan, Cesio Cristián Emanuel, Lattanzio Bernardo, Gutierrez Facundo, Dubin Arnaldo
Аннотация
PURPOSE: COVID-19 is a systemic illness with widespread microcirculatory involvement. Nevertheless, reports about the characteristics of sublingual microcirculation in patients with COVID-19 are controversial. In fact, total vascular density has been described as decreased, normal, or increased. Our goal was to assess comprehensively the sublingual microcirculation in patients with COVID-19, comparing it with that of patients with non-COVID-19 ARDS and with healthy volunteers.
MATERIALS AND METHODS: This was a multicenter cross-sectional study. We included mechanically ventilated patients with ARDS secondary to either COVID-19 (n = 62) or non-COVID-19 ARDS (n = 20), from four intensive care units. We also studied healthy volunteers (n = 20). Sublingual microcirculation was assessed by videomicroscopy.
RESULTS: Total vascular density was higher in COVID-19 ARDS than in the other groups (20.5 [18.4-21.7] vs. 17.6 [15.9-18.3] and 17.7 [16.6-19.4] mm/mm2, P < 0.001). Compared with non-COVID-19, COVID-19 group had less alterations in proportion of perfused vessels and microvascular flow index. A multivariate lineal analysis showed that total vascular density was independently associated with proportion of perfused vessels, SOFA score, base excess, and hematocrit.
CONCLUSIONS: Patients with COVID-19 exhibited a distinctive pattern of sublingual microcirculation, mainly characterized by increased vascular density. This finding could be secondary to enhanced angiogenesis.
MATERIALS AND METHODS: This was a multicenter cross-sectional study. We included mechanically ventilated patients with ARDS secondary to either COVID-19 (n = 62) or non-COVID-19 ARDS (n = 20), from four intensive care units. We also studied healthy volunteers (n = 20). Sublingual microcirculation was assessed by videomicroscopy.
RESULTS: Total vascular density was higher in COVID-19 ARDS than in the other groups (20.5 [18.4-21.7] vs. 17.6 [15.9-18.3] and 17.7 [16.6-19.4] mm/mm2, P < 0.001). Compared with non-COVID-19, COVID-19 group had less alterations in proportion of perfused vessels and microvascular flow index. A multivariate lineal analysis showed that total vascular density was independently associated with proportion of perfused vessels, SOFA score, base excess, and hematocrit.
CONCLUSIONS: Patients with COVID-19 exhibited a distinctive pattern of sublingual microcirculation, mainly characterized by increased vascular density. This finding could be secondary to enhanced angiogenesis.