Table 2.
Evolution of hemodynamic profile during daily transesophageal echocardiography assessments of COVID-19 patients ventilated for ARDS
| Day 1 (n = 18) | Day 2 (n = 10) | Day 3 (n = 12) | p value | |
|---|---|---|---|---|
| Respiratory parameters | ||||
| PaO2/FiO2 | 130 (81–217) | 128 (100–210) | 137 (98–187) | 0.066 |
| PaCO2, mmHg | 44 (33–51) | 50 (32–56) | 47 (37–57) | 0.964 |
| RR, breaths/min | 24 (22–27) | 27 (20–28) | 24 (24–30) | 0.651 |
| PEEP, cmH2O | 10 (8–12) | 10 (8–13) | 10 (10–12) | 0.444 |
| Plateau pressure, cmH2O | 23 (20–26) | 22 (18–27) | 24 (21–27) | 0.127 |
| Driving pressure, cmH2O | 12 (10–15) | 11 (9–12) | 13 (11–17) | 0.368 |
| Tidal volume, mL/kg | 5.2 (4.5–6.2) | 5.3 (4.6–6.6) | 5.5 (4.3–6.7) | 0.210 |
| Respiratory-system compliance*, mL/cmH2O | 38 (31–45) | 33 (33–53) | 37 (28–45) | 0.692 |
| Hemodynamic parameters | ||||
| Heart rate, bpm | 90 (72–109) | 93 (78–107) | 98 (89–104) | 0.368 |
| CVP, mmHg | 9 (7–10) | 7 (6–10) | 9 (5–13) | 0.678 |
| Mean blood pressure, mmHg | 102 (85–110) | 105 (87–110) | 95 (84–109) | 0.102 |
| Lactate, mmol/L | 1.17 (0.89–1.57) | 1.85 (1.24–3.01) | 1.62 (1.49–1.95) | 0.264 |
| Echocardiography indices | ||||
| Cardiac index (L/min/m2)** | 3.1 (2.5–4.2) | 2.8 (2.6–3.9) | 4.1 (3.2–4.8) | 0.115 |
| RVEDA/LVEDA | 0.55 (0.37–0.60) | 0.53 (0.35–0.66) | 0.55 (0.48–0.58) | 0.549 |
| RVFAC, % | 46 (35–50) | 40 (33–46) | 40 (32–58) | 0.821 |
| TAPSE, mm | 25 (23–29) | 24 (20–28) | 25 (23–28) | 0.368 |
| Tricuspid S′, cm/s | 16.0 (15.0–20.5) | 16.1 (14.0–18.1) | 16.8 (14.9–19.9) | 0.867 |
| TR peak velocity, m/s | 3.2 (2.9–3.6) | 3.0 (2.7–3.7) | 3.6 (2.4–3.9) | 0.060 |
| IVC diameter, mm | 22 (19–26) | 24 (14–30) | 22 (17–24) | 1.000 |
| LVEF, % | 52 (44–61) | 46 (41–64) | 55 (49–60) | 0.549 |
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