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Ultrasonic Cardiac Output Monitoring in Intubated Patients With and Without Covid-19 in the Icu: A Prospective Cohort Study Publisher



Hedayati Emami K1 ; Najafi A1 ; Mojtahedzadeh M2 ; Shariat Moharari R1 ; Ahmadi A1 ; Sharifinia H1 ; Vahidi E3, 4 ; Zarei T5 ; Hedayati Emami S6
Authors
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Authors Affiliations
  1. 1. Department of Anesthesiology & Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Clinical Pharmacy, Pharmaceutical Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Emergency Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Anesthesiology & Critical Care, Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
  6. 6. Department of Anesthesiology & Critical Care, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

Source: Frontiers in Emergency Medicine Published:2022


Abstract

Objective: The present study was conducted to compare mechanically ventilated patients with and without COVID-19 in terms of hemodynamic instability using cardiovascular indicators. Methods: This prospective cohort study assigned intubated and mechanically ventilated patients to two groups, i.e. with COVID-19 and without COVID-19. The hemodynamic parameters measured and compared between the two groups on the first day of intensive care unit (ICU) admission and the following four consecutive days using an ultrasonic cardiac output monitor (USCOM) included cardiac output (CO), systemic vascular resistance (SVR), stroke volume (SV), flow time corrected (FTc), minute distance (MD) and potential kinetic energy (PKE). Results: Forty-three patients (males: 62.7%) were assigned to the COVID-19 group and 40 (males: 64.1%) to the one without COVID-19. Insignificant differences were observed between the two groups at baseline in terms of the mean homodynamic variables measured using the USCOM (P>0.05). The mean CO increased (P=0.020), the mean SVR insignificantly changed (P=0.267), the mean MD increased (P=0.005) and PKE decreased (P=0.066) in the COVID-19 group during the five days of evaluation. In the same period, the mean CO insignificantly changed (P=0.937), the mean SVR increased (P=0.028) and changes in MD (P=0.808) and PKE (P=0.539) were insignificant in the group without COVID-19. The two groups were not significantly different in terms of the other homodynamic parameters during the follow-up (P>0.05). Conclusion: The five-day changes in the USCOM-measured homodynamic parameters were lower in the group without COVID-19 compared to in that with COVID-19. In the group without COVID-19, no statisticallysignificant differences were observed between the mean follow-up values of the variables, excluding SVR, and their baseline values. © 2022 Tehran University of Medical Sciences.