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Increased respiratory dead space could associate with coagulation activation and poor outcomes in COVID-19 ARDS

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dc.contributor.authorGraf, Jerónimo
dc.contributor.authorPérez, Rodrigo
dc.contributor.authorLópez, René
dc.date.accessioned2023-07-10T14:52:35Z
dc.date.available2023-07-10T14:52:35Z
dc.date.issued2022
dc.description.abstractPurpose: To determine whether VDPhys/VT is associated with coagulation activation and outcomes. Materials and methods: We enrolled patients with COVID-19 pneumonia who were supported by invasive mechanical ventilation and were monitored using volumetric capnography. Measurements were performed during the first 24 h of mechanical ventilation. The primary endpoint was the likelihood of being discharge alive on day 28. Results: Sixty patients were enrolled, of which 25 (42%) had high VDPhys/VT (>57%). Patients with high vs. low VDPhys/VT had higher APACHE II (10[8-13] vs. 8[6-9] points, p = 0.002), lower static compliance of the respiratory system (35[24-46] mL/cmH2O vs. 42[37-45] mL/cmH2O, p = 0.005), and higher D-dimer levels (1246[1050-1594] ng FEU/mL vs. 792[538-1159] ng FEU/mL, p = 0.001), without differences in P/F ratio (157[112-226] vs. 168[136-226], p = 0.719). Additionally, D-dimer levels correlated with VDPhys/VT (r = 0.530, p < 0.001), but not with the P/F ratio (r = -0.103, p = 0.433). Patients with high VDPhys/VT were less likely to be discharged alive on day 28 (32% vs. 71%, aHR = 3.393[1.161-9.915], p = 0.026). Conclusions: In critically ill COVID-19 patients, increased VDPhys/VT was associated with high D-dimer levels and a lower likelihood of being discharged alive. Dichotomic VDPhys/VT could help identify a high-risk subgroup of patients neglected by the P/F ratio.
dc.description.versionVersión Publicada
dc.identifier.citationGraf J, Pérez R, López R. Increased respiratory dead space could associate with coagulation activation and poor outcomes in COVID-19 ARDS. J Crit Care. 2022 Oct;71:154095. doi: 10.1016/j.jcrc.2022.154095
dc.identifier.doihttps://doi.org/10.1016/j.jcrc.2022.154095
dc.identifier.urihttps://repositorio.udd.cl/handle/11447/7675
dc.language.isoen
dc.subjectCOVID-19
dc.subjectD-dimer
dc.subjectRespiratory dead space
dc.subjectVolumetric capnography
dc.titleIncreased respiratory dead space could associate with coagulation activation and poor outcomes in COVID-19 ARDS
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceJournal of critical care
dspace.entity.typePublication

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