Cardiac Dysfunction in Critically Ill Covid-19 Patients

Region Stockholm

Status: Completed

Conditions: COVID-19; Cardiac Failure; Right Ventricular Dysfunction; ARDS, Human; Left Ventricular Dysfunction; Pulmonary Hypertension

Study type: Observational

Funder types: Other

Identifiers

NCT06197256

iNO Cardiac

Details and patient eligibility

About

We conducted an observation sub-study of the prospective randomized controlled trial "High Dose Inhaled Nitric Oxide in Acute Hypoxemic Respiratory Failure", in which we analysed the echocardiographic data collected both at baseline when patients where included and 3-5 days later for followup.

Full description

We conducted an observation sub-study of the prospective randomized controlled trial "High Dose Inhaled Nitric Oxide in Acute Hypoxemic Respiratory Failure" which was conducted in 2020/2021 during the COVID-19 pandemic on patients with ARDS due to COVID and requiring mechanical ventialtion. Patients underwent echocardiography at baseline, and were then randomized either to control, or treatment with inhaled nitric oxide, starting at 80ppm and then 40ppm. Followup echocardiography was performed 3-5 days later, and all echocardiographies were conducted by highly experienced sonographeres certified by the European Association of Cardiovascular Imaging. Analysis of these cardiac ultrasounds focused on the amount of patients showing signs of pulmonary hypertension, right ventricular failure and left ventricular failure. Several parameters were used to estimate these, and we also aimed to evalute the utility of more novel measures such as RV and LV GLS for this use in the ICU.

Enrollment: 39 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥18.
• Positive PCR for COVID-19.
• Admission to the ICU.
• Endotracheal intubation and mechanical ventilation.
• Severe hypoxemia, defined by PaO2/FiO2 < 300 mmHg.
• Inclusion in the trial "High Dose Inhaled Nitric Oxide in Acute Hypoxemic Respiratory Failure"

Exclusion criteria

• Endotracheal intubation for >72h before inclusion.
• Do not resuscitate order or other limitation of care.
• Known pregnancy.
• Cases where the treating physician opposes inclusion due to safety concerns or considerations that renders inclusion unfeasible.
• Not having had echocardiography performed during the trial period (exclusion criteria for this sub-study).