Relationship between D-dimers and dead-space on disease severity and mortality in COVID-19 acute respiratory distress syndrome : A retrospective observational cohort study
Copyright © 2023 Elsevier Inc. All rights reserved..
BACKGROUND: Despite its diagnostic and prognostic importance, physiologic dead space fraction is not included in the current ARDS definition or severity classification. ARDS caused by COVID-19 (C-ARDS) is characterized by increased physiologic dead space fraction and hypoxemia. Our aim was to investigate the relationship between dead space indices, markers of inflammation, immunothrombosis, severity and intensive care unit (ICU) mortality.
RESULTS: Retrospective data including demographics, gas exchange, ventilatory parameters, and respiratory mechanics in the first 24 h of invasive ventilation. Plasma concentrations of D-dimers and ferritin were not significantly different across C-ARDS severity categories. Weak relationships were found between D-dimers and VR (r = 0.07, p = 0.13), PETCO2/PaCO2 (r = -0.1, p = 0.02), or estimated dead space fraction (r = 0.019, p = 0.68). Age, PaO2/FiO2, pH, PETCO2/PaCO2 and ferritin, were independently associated with ICU mortality. We found no association between D-dimers or ferritin and any dead-space indices adjusting for PaO2/FiO2, days of ventilation, tidal volume, and respiratory system compliance.
CONCLUSIONS: We report no association between dead space and inflammatory markers in mechanically ventilated patients with C-ARDS. Our results support theories suggesting that multiple mechanisms, in addition to immunothrombosis, play a role in the pathophysiology of respiratory failure and degree of dead space in C-ARDS.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:77 |
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| Enthalten in: |
Journal of critical care - 77(2023) vom: 15. Okt., Seite 154313 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Camporota, Luigi [VerfasserIn] |
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| Links: |
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| Themen: |
142M471B3J |
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| Anmerkungen: |
Date Completed 07.08.2023 Date Revised 07.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jcrc.2023.154313 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM356199940 |
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| 100 | 1 | |a Camporota, Luigi |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Relationship between D-dimers and dead-space on disease severity and mortality in COVID-19 acute respiratory distress syndrome |b A retrospective observational cohort study |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Despite its diagnostic and prognostic importance, physiologic dead space fraction is not included in the current ARDS definition or severity classification. ARDS caused by COVID-19 (C-ARDS) is characterized by increased physiologic dead space fraction and hypoxemia. Our aim was to investigate the relationship between dead space indices, markers of inflammation, immunothrombosis, severity and intensive care unit (ICU) mortality | ||
| 520 | |a RESULTS: Retrospective data including demographics, gas exchange, ventilatory parameters, and respiratory mechanics in the first 24 h of invasive ventilation. Plasma concentrations of D-dimers and ferritin were not significantly different across C-ARDS severity categories. Weak relationships were found between D-dimers and VR (r = 0.07, p = 0.13), PETCO2/PaCO2 (r = -0.1, p = 0.02), or estimated dead space fraction (r = 0.019, p = 0.68). Age, PaO2/FiO2, pH, PETCO2/PaCO2 and ferritin, were independently associated with ICU mortality. We found no association between D-dimers or ferritin and any dead-space indices adjusting for PaO2/FiO2, days of ventilation, tidal volume, and respiratory system compliance | ||
| 520 | |a CONCLUSIONS: We report no association between dead space and inflammatory markers in mechanically ventilated patients with C-ARDS. Our results support theories suggesting that multiple mechanisms, in addition to immunothrombosis, play a role in the pathophysiology of respiratory failure and degree of dead space in C-ARDS | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Adult | |
| 650 | 4 | |a Coronavirus disease 2019 | |
| 650 | 4 | |a Intensive care units | |
| 650 | 4 | |a Respiratory distress syndrome | |
| 650 | 7 | |a Carbon Dioxide |2 NLM | |
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| 700 | 1 | |a Worrall, Stephanie |e verfasserin |4 aut | |
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| 700 | 1 | |a Barrett, Nicholas A |e verfasserin |4 aut | |
| 700 | 1 | |a Retter, Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a Busana, Mattia |e verfasserin |4 aut | |
| 700 | 1 | |a Collins, Patrick |e verfasserin |4 aut | |
| 700 | 1 | |a Romitti, Federica |e verfasserin |4 aut | |
| 700 | 1 | |a Hunt, Beverley J |e verfasserin |4 aut | |
| 700 | 1 | |a Rose, Louise |e verfasserin |4 aut | |
| 700 | 1 | |a Gattinoni, Luciano |e verfasserin |4 aut | |
| 700 | 1 | |a Chiumello, Davide |e verfasserin |4 aut | |
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