Acute Circulatory Failure, Acute Respiratory Distress Syndrome, Coronavirus, COVID-19, Fluid Overload, Left Ventricular Dysfunction, SARS-CoV-2, Shock
Conditions
Keywords
Hemodynamic chracteristics, Transpulmonary thermodilution, Preload-dependency, Echocardiography, Extravascular lung water, Pulmonary vascular permeability index
Brief summary
The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been declared a public health emergency of international concern. Hospitalized COVID-19-positive patients requiring ICU care is increasing along with the course of epidemic. A large number of these patients developed acute respiratory distress syndrome (ARDS) according to current data. However, the related hemodynamic characteristic has so far been rarely described.
Detailed description
The outbreak of COVID-19 is a worldwide concern. To our knowledge, the details of the hemodynamic characteristics of COVID-19 patients have not yet been well described. Besides, the cardiac injury was reported in about 7-17% of hospitalized patients with COVID-19 in previous Chinese publications and is much more common in patients admitted to ICU and non-survivors. However, no systematic assessment, including echocardiography evaluating the left ventricular function of these patients has been declared. In addition, extravascular lung water (EVLW) and pulmonary capillary permeability are two hall markers in ARDS patient's management, and transpulmonary thermodilution is a validated method to provide these values at the bedside. However, no study has reported the characteristic profile of these variables during ARDS caused by SARS-Cov2. A better knowledge of these characteristics would also be helpful in guiding their management.
Interventions
Obtained by averaging the results of three thermodilution measurements. Each thermodilution is performed by injecting a bolus (15 mL) of cold saline (less than 10°C)
DEVICEEchocardiography
Daily echocardiography evaluation
Sponsors
Bicetre Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Confirmed or suspected SARS-Cov2 cases * Patients admitted to ICU, defined as a unit in which patients can receive vasopressors. * Monitored by a transpulmonary thermodilution system (PiCCO2 (Pulsion Medical Systems, Feldkirchen, Germany) or EV1000 (Edwards Lifesciences, Irvine, United States of America).
Exclusion criteria
* SARS Cov-2 Negative * Refusal to participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of abnormal laboratory test results | Through study completion, an estimation of 6 months | — |
| Data provided by transpulmonary thermodilution-CI | Through study completion, an estimation of 6 months | Cardiac index (L/min/m2) |
| Data provided by transpulmonary thermodilution-GEDV | Through study completion, an estimation of 6 months | Global end-diastolic volume(mL/m2) |
| Data provided by transpulmonary thermodilution-EVLW | Through study completion, an estimation of 6 months | Extravascular lung water (mL/kg) |
| Data provided by transpulmonary thermodilution-PVPI | Through study completion, an estimation of 6 months | Pulmonary vascular permeability index |
| Body temperature | Through study completion, an estimation of 6 months | Body temperature(°C) |
| Blood pressure | Through study completion, an estimation of 6 months | Blood pressure in mmHg |
| Pulse (heart rate) | Through study completion, an estimation of 6 months | Pulse (heart rate) in times/minute |
| Respiratory rate | Through study completion, an estimation of 6 months | Respiratory rate in times/minute |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes of extravascular lung water measured by transpulmonary thermodilution | Change from baseline extravascular lung water at 6 months | The worst extravascular lung water |
| Changes of pulmonary vascular permeability index measured by transpulmonary thermodilution | Change from baseline extravascular lung water at 6 months | The worst pulmonary vascular permeability index |
| Correlation between the hemodynamic characteristics and 90-day mortality | Up to 90th day after inclusion | — |
| Incidence of new-onset or reversible systolic left ventricular dysfunction | Through study completion, an estimation of 6 months | Left ventricle ejection fraction, Segmental left ventricle contractility, Speckle tracking data of the left and right ventricles, Dimensions of right and left cavities and Diastolic function of left ventricle |
Countries
France
Outcome results
None listed