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Cardiac Function in Critically Ill Patients with Severe COVID: A Prospective Cross-Sectional Study in Mechanically Ventilated Patients.

Abstract : 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 PaO(2)/FiO(2) 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.
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https://hal-u-picardie.archives-ouvertes.fr/hal-03823333
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Soumis le : jeudi 20 octobre 2022 - 18:41:33
Dernière modification le : vendredi 21 octobre 2022 - 03:10:51

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Emilio Daniel Valenzuela, Pablo Mercado, Ronald Pairumani, Juan Nicolás Medel, Edward Petruska, et al.. Cardiac Function in Critically Ill Patients with Severe COVID: A Prospective Cross-Sectional Study in Mechanically Ventilated Patients.. Journal of Critical Care, 2022, 72, pp.154166. ⟨10.1016/j.jcrc.2022.154166⟩. ⟨hal-03823333⟩

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