Prognostic Impact of Serial Imaging in Severe Acute Respiratory Distress Syndrome on the Extracorporeal Membrane Oxygenation.

Autor: Balik M; Department of Anesthesiology and Intensive Care, 1st Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic., Maly M; Department of Anesthesiology and Intensive Care, 1st Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic., Huptych M; Czech Institute of Informatics, Robotics and Cybernetics (CIIRC), Czech Technical University, 190 00 Prague, Czech Republic., Mokotedi MC; Department of Radiodiagnostics and Interventional Radiology, Institute of Clinical and Experimental Medicine, 140 00 Prague, Czech Republic., Lambert L; Department of Radiology, 1st Faculty of Medicine, Charles University and General University Hospital, 128 08 Prague, Czech Republic.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 Oct 05; Vol. 12 (19). Date of Electronic Publication: 2023 Oct 05.
DOI: 10.3390/jcm12196367
Abstrakt: Background: The impact of serial imaging on the outcome of ICU patients has not been studied specifically in patients with high illness severity.
Methods: The authors sought a relationship between the numbers of antero-posterior supine chest X-rays (CXR), computed tomography (CT) examinations, and outcome in a cohort of 292 patients with severe COVID-19 ARDS collected over 24 months in a high-volume ECMO center with established ultrasound and echocardiographic diagnostics. Of the patients, 172 (59%) were obese or morbidly obese, and 119 (41%) were treated with ECMO.
Results: The median number of CXRs was eight per 14 days of the length of stay in the ICU. The CXR rate was not related to ICU survival ( p = 0.37). Patients required CT scanning in 26.5% of cases, with no relationship to the outcome except for the better ICU survival of the ECMO patients without a need for a CT scan ( p = 0.01). The odds ratio for survival associated with ordering a CT scan in an ECMO patient was 0.48, p = 0.01. The calculated savings for not routinely requesting a whole-body CT scan in every patient were 98.685 EUR/24 months.
Conclusions: Serial imaging does not impact the survival rates of patients with severe ARDS. Extracorporeal membrane oxygenation patients who did not need CT scanning had significantly better ICU outcomes.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje