Browsing by Author "Valenzuela, Emilio Daniel"
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Publication Cardiac function in critically ill patients with severe COVID: A prospective cross-sectional study in mechanically ventilated patients(2022) Valenzuela, Emilio Daniel; Mercado, Pablo; Pairumani, Ronald; Medel, Juan Nicolás; Petruska, Edward; Ugalde, Diego; Morales, Felipe; Eisen, Daniela; Araya, Carla; Montoya, Jorge; González, Alejandra; Rovegno, Maximiliano; Ramirez, Javier; Aguilera, Javiera; Hernández, Glenn; Bruhn, Alejandro; Slama, Michel; Bakker, JanPurpose: 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 PaO2/FiO2 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.