Browsing by Author "Mercado P."

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    Cardiac function in critically ill patients with severe COVID: A prospective cross-sectional study in mechanically ventilated patients
    (W.B. Saunders, 2022) Valenzuela E.D.; Gonzalez A.; Rovegno M.; Ramirez J.; Hernandez G.; Bruhn A.; Bakker J.; Mercado P.; Aguilera J.; Pairumani R.; Petruska E.; Morales F.; Araya C.; Medel J.N.; Ugalde D.; Eisen D.; Montoya J.; Slama M.
    © 2022 Elsevier Inc.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 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.