• Issac Cheong, Victoria Otero Castro, Álvarez VilariñoFederico MatíasFMDepartment of Critical Care Medicine, Sanatorio de Los Arcos, Juan B. Justo 909, Buenos Aires, Argentina., Raúl Alejandro Gómez, Mariano Andrés Furche, Pablo Martín Merlo, and Francisco Marcelo Tamagnone.
• Department of Critical Care Medicine, Sanatorio de Los Arcos, Juan B. Justo 909, Buenos Aires, Argentina. issac_cheong@hotmail.com.
• J Clin Monit Comput. 2024 Feb 1; 38 (1): 131137131-137.

PurposeThere is evidence that COVID-19 can have a clinically significant effect on the right ventricle (RV). Our objective was to enhance the efficiency of assessing RV dilation for diagnosing ACP by utilizing both linear measurements and qualitative assessment and its usefulness as an independent predictor of mortality.MethodsThis is an observational, retrospective and single-center study of the Intensive Care Unit of the Sanatorio de Los Arcos in Buenos Aires, Argentina from March 2020 to January 2022. All patients admitted with acute respiratory distress syndrome due to COVID-19 pneumonia (C-ARDS) on mechanical ventilation who were assessed by transthoracic echocardiography (TTE) were included.ResultsA total of 114 patients with C-ARDS requiring invasive mechanical ventilation were evaluated by echocardiography. 12.3% had RV dilation defined as a RV basal diameter greater than 41 mm, and 87.7% did not. Acute cor pulmonale (ACP) defined as RV dilation associated with paradoxical septal motion was found in 6.1% of patients. 7% had right ventricular systolic dysfunction according to qualitative evaluation. The different RV echocardiographic variables were studied with a logistic regression model as independent predictors of mortality. In the multivariate analysis, both the RV basal diameter and the presence of ACP showed to be independent predictors of in-hospital mortality with OR of 3.16 (95% CI 1.36-7.32) and 3.64 (95% CI 1.05-12.65) respectively.ConclusionAn increase in the RV basal diameter and the presence of ACP measured by TTE are independent predictors of in-hospital mortality in patients with C-ARDS.© 2023. The Author(s), under exclusive licence to Springer Nature B.V.

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