Respiratory failure & ventilation
Causes of Hypoxemia in COVID-19 Acute Respiratory Distress Syndrome: A Combined Multiple Inert Gas Elimination Technique and Dual-energy Computed Tomography Study
Authors' conclusion
These data support the hypothesis of a highly multifactorial genesis of hypoxemia.
Study context
- Population
- Patients with COVID-19 acute respiratory distress syndrome (ARDS) intubated for less than 7 days
- Participants
- 10 patients
- Outcome
- Relative contribution of shunt, ventilation-perfusion mismatch and diffusion limitation to hypoxemia, and relationship with lung tissue and blood distribution
Methodological detailsprospective, combined multiple inert gas elimination technique (MIGET) and dual-energy CT
- Prospective
- Combined MIGET and dual-energy CT
Main finding
As reported in the abstract
- Shunt (MIGET), mean ± SD
- 25 ± 16%
- Dead space (MIGET), mean ± SD
- 53 ± 11%
- Ventilation-perfusion mismatch (LogSD, Q)
- 0.86 ± 0.33
- Shunt proportional to blood volume of atelectasis
- R2 = 0.70, P = 0.003
- V˙A/Q˙T mismatch correlated with blood volume of poorly aerated tissue
- R2 = 0.54, P = 0.016
- Overperfusion coefficient related to Pao2/Fio2
- R2 = 0.66, P = 0.002
- Overperfusion coefficient related to excess tissue mass
- R2 = 0.84, P < 0.001
- Overperfusion coefficient related to Etco2/Paco2
- R2 = 0.63, P = 0.004
Observational data: associations, not effects.
Further findings
Sample characteristics and mortality
- Age, yr
- 51 ± 15
- Pao2/Fio2, mmHg
- 172 ± 86
- Mortality
- 50%
Original publication
Causes of Hypoxemia in COVID-19 Acute Respiratory Distress Syndrome: A Combined Multiple Inert Gas Elimination Technique and Dual-energy Computed Tomography Study. Anesthesiology. Published 1 September 2023. doi:10.
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