The ∆Pv-aCO2/∆Ca-vO2 ratio as a predictor of mortality in patients with severe acute respiratory distress syndrome related to COVID-19

Sánchez Díaz, Jesús Salvador; Peniche Moguel, Karla Gabriela; Reyes-Ruiz, José Manuel; Pérez Nieto, Orlando Rubén; Escarramán Martínez, Diego; Zamarrón López, Eder Iván; Calyeca Sánchez, María Verónica

doi:10.1371/journal.pone.0290272

Cited by 2 publications

(1 citation statement)

References 33 publications

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“…In COVID-19 patients with ARDS, the ratio of Pv-aCO 2 to Ca-vO 2 was significantly associated with mortality, with an AUC of 0.89 (95% CI 0.598–0.774, P = 0.001). The best cutoff found by the authors was 2.1 mmHg/mL [ 81 ].…”

Section: Introductionmentioning

confidence: 99%

Recent advances in cardiorespiratory monitoring in acute respiratory distress syndrome patients

Chiumello,

Fioccola

2024

j intensive care

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Background Recent advances on cardiorespiratory monitoring applied in ARDS patients undergoing invasive mechanical ventilation and noninvasive ventilatory support are available in the literature and may have potential prognostic implication in ARDS treatment. Main body The measurement of oxygen saturation by pulse oximetry is a valid, low-cost, noninvasive alternative for assessing arterial oxygenation. Caution must be taken in patients with darker skin pigmentation, who may experience a greater incidence of occult hypoxemia. Dead space surrogates, which are easy to calculate, have important prognostic implications. The mechanical power, which can be automatically computed by intensive care ventilators, is an important parameter correlated with ventilator-induced lung injury and outcome. In patients undergoing noninvasive ventilatory support, the use of esophageal pressure can measure inspiratory effort, avoiding possible delays in endotracheal intubation. Fluid responsiveness can also be evaluated using dynamic indices in patients ventilated at low tidal volumes (< 8 mL/kg). In patients ventilated at high levels of positive end expiratory pressure (PEEP), the PEEP test represents a valid alternative to passive leg raising. There is growing evidence on alternative parameters for evaluating fluid responsiveness, such as central venous oxygen saturation variations, inferior vena cava diameter variations and capillary refill time. Conclusion Careful cardiorespiratory monitoring in patients affected by ARDS is crucial to improve prognosis and to tailor treatment via mechanical ventilatory support.

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Section: Introductionmentioning

confidence: 99%

Recent advances in cardiorespiratory monitoring in acute respiratory distress syndrome patients

Chiumello,

Fioccola

2024

j intensive care

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Acute Kidney Injury in the Context of COVID-19: An Analysis in Hospitalized Mexican Patients

Borrego-Moreno,

Cárdenas-de Luna,

Márquez-Castillo

et al. 2024

Infectious Disease Reports

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During the COVID-19 pandemic, a considerable proportion of patients developed a severe condition that included respiratory failure, shock, or multiple organ dysfunction. Acute Kidney Injury (AKI) has been recognized as a possible cause of severe COVID-19 development. Given this, this study investigates the occurrence and consequences of AKI in Mexican patients to contribute to better knowledge and management of this problem. Methods: Using a retrospective observational cohort methodology, we investigated 313 cases from a cohort of 1019 patients diagnosed with COVID-19 at the IMSS Zacatecas General Hospital of Zone No. 1 in 2020. The prevalence of AKI was determined using the AKIN criteria based on serum creatinine levels and a detailed review of demographic characteristics, medical history, comorbidities, and clinical development. Results: The data showed a 25.30% prevalence of AKI among patients infected with severe COVID-19. Remarkably, these patients with AKI exhibited an advanced age (>65 years), arterial hypertension, a higher number of white blood cells during admission and the hospital stay, and elevated levels of C-reactive protein, serum creatinine, and blood urea nitrogen (BUN). Clinically, patients with AKI had signs of prostration, pneumonia, and the requirement for ventilatory assistance when compared to those without AKI. Finally, those diagnosed with AKI and COVID-19 had a 74% death rate. Relative risk analyses indicated that age (>65 years), arterial hypertension, high creatinine levels, endotracheal intubation, and pneumonia are associated with the development of AKI. On the other hand, among the protective factors against AKI, high hemoglobin levels and the consumption of statins during COVID-19 were found. Conclusions: The findings of this study underscore the significance of promptly identifying and effectively managing AKI to potentially alleviate the negative consequences of this complication within the Mexican population during COVID-19.

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The ∆Pv-aCO2/∆Ca-vO2 ratio as a predictor of mortality in patients with severe acute respiratory distress syndrome related to COVID-19

Cited by 2 publications

References 33 publications

Recent advances in cardiorespiratory monitoring in acute respiratory distress syndrome patients

Recent advances in cardiorespiratory monitoring in acute respiratory distress syndrome patients

Acute Kidney Injury in the Context of COVID-19: An Analysis in Hospitalized Mexican Patients

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