Cargando…

Prognostic Impact of Serial Imaging in Severe Acute Respiratory Distress Syndrome on the Extracorporeal Membrane Oxygenation

Background: The impact of serial imaging on the outcome of ICU patients has not been studied specifically in patients with high illness severity. Methods: The authors sought a relationship between the numbers of antero-posterior supine chest X-rays (CXR), computed tomography (CT) examinations, and o...

Descripción completa

Detalles Bibliográficos
Autores principales: Balik, Martin, Maly, Michal, Huptych, Michal, Mokotedi, Masego Candy, Lambert, Lukas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573453/
https://www.ncbi.nlm.nih.gov/pubmed/37835011
http://dx.doi.org/10.3390/jcm12196367
_version_ 1785120467472875520
author Balik, Martin
Maly, Michal
Huptych, Michal
Mokotedi, Masego Candy
Lambert, Lukas
author_facet Balik, Martin
Maly, Michal
Huptych, Michal
Mokotedi, Masego Candy
Lambert, Lukas
author_sort Balik, Martin
collection PubMed
description Background: The impact of serial imaging on the outcome of ICU patients has not been studied specifically in patients with high illness severity. Methods: The authors sought a relationship between the numbers of antero-posterior supine chest X-rays (CXR), computed tomography (CT) examinations, and outcome in a cohort of 292 patients with severe COVID-19 ARDS collected over 24 months in a high-volume ECMO center with established ultrasound and echocardiographic diagnostics. Of the patients, 172 (59%) were obese or morbidly obese, and 119 (41%) were treated with ECMO. Results: The median number of CXRs was eight per 14 days of the length of stay in the ICU. The CXR rate was not related to ICU survival (p = 0.37). Patients required CT scanning in 26.5% of cases, with no relationship to the outcome except for the better ICU survival of the ECMO patients without a need for a CT scan (p = 0.01). The odds ratio for survival associated with ordering a CT scan in an ECMO patient was 0.48, p = 0.01. The calculated savings for not routinely requesting a whole-body CT scan in every patient were 98.685 EUR/24 months. Conclusions: Serial imaging does not impact the survival rates of patients with severe ARDS. Extracorporeal membrane oxygenation patients who did not need CT scanning had significantly better ICU outcomes.
format Online
Article
Text
id pubmed-10573453
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-105734532023-10-14 Prognostic Impact of Serial Imaging in Severe Acute Respiratory Distress Syndrome on the Extracorporeal Membrane Oxygenation Balik, Martin Maly, Michal Huptych, Michal Mokotedi, Masego Candy Lambert, Lukas J Clin Med Article Background: The impact of serial imaging on the outcome of ICU patients has not been studied specifically in patients with high illness severity. Methods: The authors sought a relationship between the numbers of antero-posterior supine chest X-rays (CXR), computed tomography (CT) examinations, and outcome in a cohort of 292 patients with severe COVID-19 ARDS collected over 24 months in a high-volume ECMO center with established ultrasound and echocardiographic diagnostics. Of the patients, 172 (59%) were obese or morbidly obese, and 119 (41%) were treated with ECMO. Results: The median number of CXRs was eight per 14 days of the length of stay in the ICU. The CXR rate was not related to ICU survival (p = 0.37). Patients required CT scanning in 26.5% of cases, with no relationship to the outcome except for the better ICU survival of the ECMO patients without a need for a CT scan (p = 0.01). The odds ratio for survival associated with ordering a CT scan in an ECMO patient was 0.48, p = 0.01. The calculated savings for not routinely requesting a whole-body CT scan in every patient were 98.685 EUR/24 months. Conclusions: Serial imaging does not impact the survival rates of patients with severe ARDS. Extracorporeal membrane oxygenation patients who did not need CT scanning had significantly better ICU outcomes. MDPI 2023-10-05 /pmc/articles/PMC10573453/ /pubmed/37835011 http://dx.doi.org/10.3390/jcm12196367 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Balik, Martin
Maly, Michal
Huptych, Michal
Mokotedi, Masego Candy
Lambert, Lukas
Prognostic Impact of Serial Imaging in Severe Acute Respiratory Distress Syndrome on the Extracorporeal Membrane Oxygenation
title Prognostic Impact of Serial Imaging in Severe Acute Respiratory Distress Syndrome on the Extracorporeal Membrane Oxygenation
title_full Prognostic Impact of Serial Imaging in Severe Acute Respiratory Distress Syndrome on the Extracorporeal Membrane Oxygenation
title_fullStr Prognostic Impact of Serial Imaging in Severe Acute Respiratory Distress Syndrome on the Extracorporeal Membrane Oxygenation
title_full_unstemmed Prognostic Impact of Serial Imaging in Severe Acute Respiratory Distress Syndrome on the Extracorporeal Membrane Oxygenation
title_short Prognostic Impact of Serial Imaging in Severe Acute Respiratory Distress Syndrome on the Extracorporeal Membrane Oxygenation
title_sort prognostic impact of serial imaging in severe acute respiratory distress syndrome on the extracorporeal membrane oxygenation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573453/
https://www.ncbi.nlm.nih.gov/pubmed/37835011
http://dx.doi.org/10.3390/jcm12196367
work_keys_str_mv AT balikmartin prognosticimpactofserialimaginginsevereacuterespiratorydistresssyndromeontheextracorporealmembraneoxygenation
AT malymichal prognosticimpactofserialimaginginsevereacuterespiratorydistresssyndromeontheextracorporealmembraneoxygenation
AT huptychmichal prognosticimpactofserialimaginginsevereacuterespiratorydistresssyndromeontheextracorporealmembraneoxygenation
AT mokotedimasegocandy prognosticimpactofserialimaginginsevereacuterespiratorydistresssyndromeontheextracorporealmembraneoxygenation
AT lambertlukas prognosticimpactofserialimaginginsevereacuterespiratorydistresssyndromeontheextracorporealmembraneoxygenation