key: cord-329381-uwae8738
authors: Evrard, Bruno; Goudelin, Marine; Montmagnon, Noelie; Fedou, Anne-Laure; Lafon, Thomas; Vignon, Philippe
title: Cardiovascular phenotypes in ventilated patients with COVID-19 acute respiratory distress syndrome
date: 2020-05-18
journal: Crit Care
DOI: 10.1186/s13054-020-02958-8
sha: 
doc_id: 329381
cord_uid: uwae8738

nan

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The higher prevalence of LV failure and lower cardiac index in patients with flu-related ARDS is presumably related to septic cardiomyopathy since they sustained associated septic shock more frequently than COVID-19 patients. Depressed indices of RV systolic function and elevated central venous pressure reflecting systemic venous congestion reflect the higher prevalence of RV failure in flu ARDS patients (Table 1 ). This presumably results from the lower P/F, higher driving pressure, and lower respiratory-system compliance observed in this group. COVID-19 patients with ACP tended to have lower respiratory-system compliance than their counterparts, presumably due to distinct ARDS phenotypes [6] . This pilot study is limited by its small sample size and the retrospective comparison with historical flu-related ARDS patients.

This first study assessing hemodynamically ventilated COVID-19 patients with TEE shows a lower **Calculated as the tidal volume divided by the driving pressure (difference between the inspiratory plateau pressure and positive end-expiratory pressure) ***One patient was diagnosed with a Tako-tsubo syndrome during transesophageal echocardiography examination performed shortly after tracheal intubation, after 6 days of high-flow nasal cannula; full recovery of left ventricular systolic function was documented under mechanical ventilation 10 days later ****Measured using the Doppler method applied at the left ventricular outflow tract *****As per April 24, with still 6 patients hospitalized in the intensive care unit, 5 of them being invasively ventilated prevalence of LV and RV failure than in flu-related ARDS patients. Whether herein reported cardiovascular phenotypes are influenced by the type of COVID-19 ARDS remains to be determined [6] . These preliminary data warrant confirmation in large-scale multicenter cohorts. Funding None

Ethics approval and consent to participate Local Ethical Committee approval #368-2020-24, which waived the need for informed consent. All patients agreed on the use of anonymized information as per the French law on the General Data Protection Regulation (GDPR).

Author details Abbreviations: RR respiratory rate, PEEP positive end-expiratory pressure, CVP central venous pressure, RVEDA right ventricular end-diastolic area, LVEDA left ventricular end-diastolic area, RVFAC right ventricular fractional area change, TAPSE tricuspid annular plane systolic excursion, TR tricuspid regurgitation, IVC inferior vena cava, LVEF left ventricular ejection fraction *Calculated as the tidal volume divided by the driving pressure (difference between the inspiratory plateau pressure and positive end-expiratory pressure) **Measured using the Doppler method applied at the left ventricular outflow tract

Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a singlecentered, retrospective, observational study

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Cardiovascular clusters in septic shock combining clinical and echocardiographic parameters: a post hoc analysis

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COVID-19 pneumonia: ARDS or not?

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