Respiratory and peripheral muscular ultrasound characteristics in ICU COVID 19 ARDS patients
| Autor: | M. Bonifazi, Paolo Formenti, Davide Chiumello, Silvia Coppola, Stefano Cenci, Francesca Bichi, Valentina Castagna, Tommaso Pozzi, Michele Umbrello |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
ARDS medicine.medical_treatment Diaphragmatic breathing Critical Care and Intensive Care Medicine Article Internal medicine ICU Intensive Care Unit Medicine Humans Respiratory system ARDS acute respiratory distress syndrome Ultrasonography Mechanical ventilation Respiratory Distress Syndrome Grayscale analysis business.industry SARS-CoV-2 Ultrasound Echogenicity COVID-19 NIV non-invasive ventilation Covid19 MV mechanical ventilation medicine.disease COVID 19 the novel coronavirus disease 2019 Diaphragm (structural system) Intensive Care Units Parasternal line RFCSA rectus femoris cross sectional area Cardiology Muscular ultrasound business |
| Zdroj: | Journal of Critical Care |
| ISSN: | 1557-8615 |
| Popis: | Purpose Severe cases of coronavirus disease 2019 develop ARDS requiring admission to the ICU. This study aimed to investigate the ultrasound characteristics of respiratory and peripheral muscles of patients affected by COVID19 who require mechanical ventilation. Materials and methods This is a prospective observational study. We performed muscle ultrasound at the admission of ICU in 32 intubated patients with ARDS COVID19. The ultrasound was comprehensive of thickness and echogenicity of both parasternal intercostal and diaphragm muscles, and cross-sectional area and echogenicity of the rectus femoris. Results Patients who survived showed a significantly lower echogenicity score as compared with those who did not survive for both parasternal intercostal muscles. Similarly, the diaphragmatic echogenicity was significantly different between alive or dead patients. There was a significant correlation between right parasternal intercostal or diaphragm echogenicity and the cumulative fluid balance and urine protein output. Similar results were detected for rectus femoris echogenicity. Conclusions The early changes detected by echogenicity ultrasound suggest a potential benefit of proactive early therapies designed to preserve respiratory and peripheral muscle architecture to reduce days on MV, although what constitutes a clinically significant change in muscle echogenicity remains unknown. |
| Databáze: | OpenAIRE |
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