Ultrasonic cardiac output monitoring in intubated patients with and without COVID-19 in the ICU: a prospective cohort study

Kaveh  Hedayati Emami; Atabak Najafi; Mojtaba Mojtahedzadeh; Reza Shariat Moharari; Arezoo Ahmadi; Hamidreza Sharifinia; Elnaz Vahidi; Tayebeh Zarei; Setareh  Hedayati Emami

doi:10.18502/fem.v6i2.8711

Kaveh Hedayati Emami Department of Anesthesiology & Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Atabak Najafi Department of Anesthesiology & Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mojtaba Mojtahedzadeh Department of Clinical Pharmacy, Pharmaceutical Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Reza Shariat Moharari Department of Anesthesiology & Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Arezoo Ahmadi Department of Anesthesiology & Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Hamidreza Sharifinia Department of Anesthesiology & Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Elnaz Vahidi Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Tayebeh Zarei Department of Anesthesiology & Critical Care, Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Setareh Hedayati Emami Department of Anesthesiology & Critical Care, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/fem.v6i2.8711

Keywords: Artificial Respiration; Cardiac Output; COVID-19; Intensive Care Units; Point of Care; Ultrasonography

Abstract

Objective: The present study was conducted to compare mechanically ventilated patients with and without COVID-19 in terms of hemodynamic instability using cardiovascular indicators.

Methods: This prospective cohort study assigned intubated and mechanically ventilated patients to two groups, i.e. with COVID-19 and without COVID-19. The hemodynamic parameters measured and compared between the two groups on the first day of ICU admission and the following four consecutive days using an ultrasonic cardiac output monitor (USCOM) included cardiac output (CO), systemic vascular resistance (SVR), stroke volume (SV), flow time corrected (FTc), minute distance (MD) and potential kinetic energy (PKE).

Results: Forty-three patients (males: 62.7%) were assigned to the COVID-19 group and 40 (males: 64.1%) to the one without COVID-19. Insignificant differences were observed between the two groups at baseline in terms of the mean homodynamic variables measured using the USCOM (P>0.05). The mean CO increased (P=0.020), the mean SVR insignificantly changed (P=0.267), the mean MD increased (P=0.005) and PKE decreased (P=0.066) in the COVID-19 group during the five days of evaluation. In the same period, the mean CO insignificantly changed (P=0.937), the mean SVR increased (P=0.028) and changes in MD (P=0.808) and PKE (P=0.539) were insignificant in the group without COVID-19. The two groups were not significantly different in terms of the other homodynamic parameters during the follow-up (P>0.05).

Conclusion: The five-day changes in the USCOM-measured homodynamic parameters were lower in the group without COVID-19 compared to in that with COVID-19. In the group without COVID-19, no statistically-significant differences were observed between the mean follow-up values of the variables, excluding SVR, and their baseline values.