ArticleAnnals of intensive care2015
Echocardiographic detection of transpulmonary bubble transit during acute respiratory distress syndrome.
Article in Annals of intensive care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 29 citations in OpenAlex.
- Shunt: pathophysiological mechanisms and clinical implications of ineffective circulating volume.Frontiers in physiology · 2026Review
- Transpulmonary bubble transit in patients hospitalised with COVID-19 pneumonia.BMJ open respiratory research · 2025Article
- Article
- Pathophysiology of Hypoxemia in COVID-19 Lung Disease.Clinics in chest medicine · 2023Review
- Agitated Saline Contrast Injection in Patients with Severe Hypoxemia.Journal of intensive care medicine · 2023Review
- Indications, Clinical Impact, and Complications of Critical Care Transesophageal Echocardiography: A Scoping Review.Journal of intensive care medicine · 2023Article
- Pathophysiology and Clinical Meaning of Ventilation-Perfusion Mismatch in the Acute Respiratory Distress Syndrome.Biology · 2022Review
- Acute Respiratory Distress Syndrome and Shunt Detection With Bubble Studies: A Systematic Review and Meta-Analysis.Critical care explorations · 2022Review
- Endotheliitis, Shunts, and Ventilation-Perfusion Mismatch in Coronavirus Disease 2019: A Literature Review of Disease Mechanisms.Annals of medicine and surgery (2012) · 2022Review
- Impairment of hypoxic pulmonary vasoconstriction in acute respiratory distress syndrome.European respiratory review : an official journal of the European Respiratory Society · 2021Review
- Reply to Chiang and Gupta and to SwensonAmerican journal of respiratory and critical care medicine · 2021Article
- Reply to CherianAmerican journal of respiratory and critical care medicine · 2021Article
- Article
- Pulmonary Vascular Dilatation Detected by Automated Transcranial Doppler in COVID-19 Pneumonia.American journal of respiratory and critical care medicine · 2020Article
- Bubble Trouble in COVID-19.American journal of respiratory and critical care medicine · 2020Article
- Is hypoxemia explained by intracardiac or intrapulmonary shunt in COVID-19-related acute respiratory distress syndrome?Annals of intensive care · 2020Article
- Femoral Nailing in a Porcine Model Causes Bone Marrow Emboli in the Lungs and Systemic Emboli in the Heart and Brain.JB & JS open accessArticle
- Cardiac index is associated with oxygenation in COVID-19 acute respiratory distress syndrome.Pulmonary circulationArticle
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTranspulmonary bubble transit (TPBT) detected with contrast echocardiography is reported as a sign of intrapulmonary shunt during cirrhosis or exercise in healthy humans. However, its physiological meaning is not clear during acute respiratory distress syndrome (ARDS). Our aim was to determine the prevalence, significance, and prognosis of TPBT detection during ARDS.
methodsThis was a prospective observational study in an academic medical intensive care unit in France. Two hundred and sixteen consecutive patients with moderate-to-severe ARDS underwent transesophageal echocardiography with modified gelatine contrast. Moderate-to-large TPBT was defined as right-to-left passage of at least ten bubbles through a pulmonary vein more than three cardiac cycles after complete opacification of the right atrium. Patients with intra-cardiac shunt through patent foramen ovale were excluded.
resultsThe prevalence of moderate-to-large TPBT was 26% (including 42 patients with moderate and 15 with large TPBT). Patients with moderate-to-large TPBT had higher values of cardiac index and heart rate as compared to those without TPBT. There was no significant difference in PaO2/FIO2 ratio between groups, and TPBT was not influenced by end-expiratory positive pressure level in 93% of tested patients. Prevalence of septic shock was higher in the group with moderate-to-large TPBT. Patients with moderate-to-large TPBT had fewer ventilator-free days and intensive care unit-free days within the first 28 days, and higher in-hospital mortality as compared to others.
conclusionsModerate-to-large TPBT was detected with contrast echocardiography in 26% of patients with ARDS. This finding was associated with a hyperdynamic and septic state, but did not influence oxygenation.
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