• Emilio Daniel Valenzuela, Pablo Mercado, Ronald Pairumani, Juan Nicolás Medel, Edward Petruska, Diego Ugalde, Felipe Morales, Daniela Eisen, Carla Araya, Jorge Montoya, Alejandra Gonzalez, Maximiliano Rovegno, Javier Ramirez, Javiera Aguilera, Glenn Hernández, Alejandro Bruhn, Michel Slama, and Jan Bakker.
• Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address: eevalenzuela@uc.cl.
• J Crit Care. 2022 Dec 1; 72: 154166154166.

PurposeTo evaluate cardiac function in mechanically ventilated patients with COVID-19.Materials And MethodsProspective, 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.Results140 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.ConclusionsRight 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.Copyright © 2022 Elsevier Inc. All rights reserved.

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