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Annals of intensive care · Aug 2020
LetterIs hypoxemia explained by intracardiac or intrapulmonary shunt in COVID-19-related acute respiratory distress syndrome?
- Paul Masi, François Bagate, Thomas d'Humières, Lara Al-Assaad, Laure Abou Chakra, Genevieve Derumeaux, and Armand Mekontso Dessap.
- Service de Médecine Intensive Réanimation, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France. paul.masi@aphp.fr.
- Ann Intensive Care. 2020 Aug 6; 10 (1): 108.
AbstractHypoxemia 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 cmH2O/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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