Is hypoxemia explained by intracardiac or intrapulmonary shunt in COVID-19-related acute respiratory distress syndrome?

Hypoxemia is the main feature of COVID-19-related acute respiratory distress syndrome (C-ARDS), but its underlying mechanisms are debated, especially in patients with low respiratory system elastance (Ers). We assessed 60 critically ill patients hospitalized in our intensive care unit for C-ARDS. We...

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Autores principales: Masi, Paul, Bagate, François, d’Humières, Thomas, Al-Assaad, Lara, Abou Chakra, Laure, Derumeaux, Genevieve, Mekontso Dessap, Armand
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2020
Materias:
Letter to the Editor
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7407421/
https://www.ncbi.nlm.nih.gov/pubmed/32761524
http://dx.doi.org/10.1186/s13613-020-00726-z
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author Masi, Paul
Bagate, François
d’Humières, Thomas
Al-Assaad, Lara
Abou Chakra, Laure
Derumeaux, Genevieve
Mekontso Dessap, Armand
author_facet Masi, Paul
Bagate, François
d’Humières, Thomas
Al-Assaad, Lara
Abou Chakra, Laure
Derumeaux, Genevieve
Mekontso Dessap, Armand
author_sort Masi, Paul
collection PubMed
description Hypoxemia is the main feature of COVID-19-related acute respiratory distress syndrome (C-ARDS), but its underlying mechanisms are debated, especially in patients with low respiratory system elastance (Ers). We assessed 60 critically ill patients hospitalized in our intensive care unit for C-ARDS. We used contrast transthoracic echocardiography to assess patent foramen ovale (PFO) shunt and transpulmonary bubble transit (TPBT). The median Ers was 32 cmH(2)O/L. PFO shunt was detected in six (10%) patients and TPBT in 12 (20%) patients. PFO shunt and TPBT were similar in patients with higher or lower Ers. In conclusion, PFO and TPBT do not seem to be the main drivers of hypoxemia in C-ARDS, especially in patients with lower Ers.
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spelling pubmed-74074212020-08-06 Is hypoxemia explained by intracardiac or intrapulmonary shunt in COVID-19-related acute respiratory distress syndrome? Masi, Paul Bagate, François d’Humières, Thomas Al-Assaad, Lara Abou Chakra, Laure Derumeaux, Genevieve Mekontso Dessap, Armand Ann Intensive Care Letter to the Editor Hypoxemia is the main feature of COVID-19-related acute respiratory distress syndrome (C-ARDS), but its underlying mechanisms are debated, especially in patients with low respiratory system elastance (Ers). We assessed 60 critically ill patients hospitalized in our intensive care unit for C-ARDS. We used contrast transthoracic echocardiography to assess patent foramen ovale (PFO) shunt and transpulmonary bubble transit (TPBT). The median Ers was 32 cmH(2)O/L. PFO shunt was detected in six (10%) patients and TPBT in 12 (20%) patients. PFO shunt and TPBT were similar in patients with higher or lower Ers. In conclusion, PFO and TPBT do not seem to be the main drivers of hypoxemia in C-ARDS, especially in patients with lower Ers. Springer International Publishing 2020-08-06 /pmc/articles/PMC7407421/ /pubmed/32761524 http://dx.doi.org/10.1186/s13613-020-00726-z Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Letter to the Editor
Masi, Paul
Bagate, François
d’Humières, Thomas
Al-Assaad, Lara
Abou Chakra, Laure
Derumeaux, Genevieve
Mekontso Dessap, Armand
Is hypoxemia explained by intracardiac or intrapulmonary shunt in COVID-19-related acute respiratory distress syndrome?
title Is hypoxemia explained by intracardiac or intrapulmonary shunt in COVID-19-related acute respiratory distress syndrome?
title_full Is hypoxemia explained by intracardiac or intrapulmonary shunt in COVID-19-related acute respiratory distress syndrome?
title_fullStr Is hypoxemia explained by intracardiac or intrapulmonary shunt in COVID-19-related acute respiratory distress syndrome?
title_full_unstemmed Is hypoxemia explained by intracardiac or intrapulmonary shunt in COVID-19-related acute respiratory distress syndrome?
title_short Is hypoxemia explained by intracardiac or intrapulmonary shunt in COVID-19-related acute respiratory distress syndrome?
title_sort is hypoxemia explained by intracardiac or intrapulmonary shunt in covid-19-related acute respiratory distress syndrome?
topic Letter to the Editor
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7407421/
https://www.ncbi.nlm.nih.gov/pubmed/32761524
http://dx.doi.org/10.1186/s13613-020-00726-z
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