Evidence map›Paper›PMID 36335383›Full record

ArticleJournal of cardiothoracic surgery2022

Diagnosis and treatment of right ventricular dysfunction in patients with COVID-19 on veno-venous extra-corporeal membrane oxygenation.

Maziar Khorsandi, Jeffrey Keenan, Mackenzie Adcox, Ariyan Tabesh, Jenelle Badulak, Jay Pal, Michael Mulligan

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cardiothoracic surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 45% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Maziar KhorsandiDivision of Cardiothoracic Surgery, University of Washington Medical Center, 1959 NE Pacific St, Seattle, WA, 98195, USA. mkhors@uw.edu.
Jeffrey KeenanDivision of Cardiothoracic Surgery, University of Washington Medical Center, 1959 NE Pacific St, Seattle, WA, 98195, USA.
Mackenzie AdcoxDivision of Cardiothoracic Surgery, University of Washington Medical Center, 1959 NE Pacific St, Seattle, WA, 98195, USA.
Ariyan TabeshDivision of Cardiothoracic Surgery, University of Washington Medical Center, 1959 NE Pacific St, Seattle, WA, 98195, USA.
Jenelle BadulakDivision of Pulmonary, Critical Care and Sleep Medicine, University of Washington Medical Center, Seattle, WA, USA.
Jay PalDivision of Cardiothoracic Surgery, University of Washington Medical Center, 1959 NE Pacific St, Seattle, WA, 98195, USA.
Michael MulliganDivision of Cardiothoracic Surgery, University of Washington Medical Center, 1959 NE Pacific St, Seattle, WA, 98195, USA.
University of Washington Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVeno-venous (VV) extracorporeal membrane oxygenation (ECMO) is an effective, but highly resource intensive salvage treatment option in COVID patients with acute respiratory distress syndrome (ARDS). Right ventricular (RV) dysfunction is a known sequelae of COVID-19 induced ARDS, yet there is a paucity of data on the incidence and determinants of RV dysfunction on VV ECMO. We retrospectively examined the determining factors leading to RV failure and means of early identification of this phenomenon in patients on VV ECMO.

methodsThe data was extracted from March 2020 to March 2021 from the regional University of Washington Extracorporeal Life Support database. The inclusion criteria included patients > 18 years of age with diagnosis of COVID-19. All had already been intubated and mechanically ventilated prior to VV ECMO deployment. Univariate analysis was performed to identify risk factors and surrogate markers for RV dysfunction. In addition, we compared outcomes between those with and without RV dysfunction.

resultsOf the 33 patients that met inclusion criteria, 14 (42%) had echocardiographic evidence of RV dysfunction, 3 of whom were placed on right ventricular assist device support. Chronic lung disease was an independent risk factor for RV dysfunction (p = 0.0002). RV dysfunction was associated with a six-fold increase in troponin I (0.07 ng/ml vs. 0.44 ng/ml, p = 0.039) and four-fold increase in brain natriuretic peptide (BNP) (158 pg/ml vs. 662 pg/ml, p = 0.037). Deep vein thrombosis (DVT, 21% vs. 43%, p = 0.005) and pulmonary embolism (PE, 11% vs. 21%, p = 0.045) were found to be nearly twice as common in the RV dysfunction group. Total survival rate to hospital discharge was 39%. Data trended towards shorter duration of hospital stay (47 vs. 65.6 days, p = 0.15), shorter duration of ECMO support (21 days vs. 36 days, p = 0.06) and improved survival rate to hospital discharge (42.1% vs. 35.7%, p = 0.47) for those with intact RV function compared to the RV dysfunction group.

conclusionsRV dysfunction in critically ill patients with COVID-19 pneumonia in common. Trends of troponin I and BNP may be important surrogates for monitoring RV function in patients on VV ECMO. We recommend echocardiographic assessment of the RV on such patients.

Indexed as

COVID-19Extracorporeal Membrane OxygenationRespiratory Distress SyndromeVentricular Dysfunction, RightHumansRetrospective StudiesTroponin ITroponin ICOVID-19Extra-corporeal membrane oxygenationRight ventricular assistRight ventricular failure

Identifiers

PMID36335383
PMCPMC9637294
OpenAlexW4308318881

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.