Haemodynamic monitoring and management in COVID-19 intensive care patients: an International survey.

Tytuł:: Haemodynamic monitoring and management in COVID-19 intensive care patients: an International survey.
Autorzy:: Michard F; MiCo, Denens, Switzerland. Electronic address: .
Malbrain ML; Intensive Care Unit, University Hospital Brussel, Jette, Belgium & Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.
Martin GS; Emory University and Grady Memorial Hospital, Atlanta, USA.
Fumeaux T; Intensive Care Unit, Nyon Hospital, Nyon, Switzerland.
Lobo S; Intensive Care Division, Hospital de Base - FAMERP, Sao Jose do Rio Preto, SP, Brazil.
Gonzalez F; Intensive Care Department, Hospital Garcia de Orta, Almada, Portugal.
Pinho-Oliveira V; Department of Anesthesia, Hospital CUF Viseu, Viseu, Portugal.
Constantin JM; Department of Anesthesia & Critical Care, La Pitié Salpetriere Hospital, University Paris-Sorbonne, Paris, France.
Źródło:: Anaesthesia, critical care & pain medicine [Anaesth Crit Care Pain Med] 2020 Oct; Vol. 39 (5), pp. 563-569. Date of Electronic Publication: 2020 Aug 09.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: Issy-les-Moulineaux cedex, France : Published by Elsevier Masson SAS on behalf of the Société française d'anesthésie et de réanimation (Sfar), [2015]-
MeSH Terms:: Betacoronavirus*
Health Care Surveys*
Hemodynamic Monitoring*
Pandemics*
Coronavirus Infections/*therapy
Critical Care/*methods
Pneumonia, Viral/*therapy
Africa/epidemiology ; Americas/epidemiology ; Asia/epidemiology ; Australia/epidemiology ; COVID-19 ; Cardiotonic Agents/therapeutic use ; Coronavirus Infections/complications ; Coronavirus Infections/epidemiology ; Coronavirus Infections/physiopathology ; Disease Management ; Echocardiography/statistics & numerical data ; Europe/epidemiology ; Fluid Therapy ; Hemodynamics/drug effects ; Humans ; Oxygen/blood ; Pneumonia, Viral/complications ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/physiopathology ; Procedures and Techniques Utilization ; Pulmonary Edema/etiology ; Pulmonary Edema/physiopathology ; SARS-CoV-2 ; Shock/etiology ; Shock/physiopathology ; Vasoconstrictor Agents/therapeutic use
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Contributed Indexing:: Keywords: Acute circulatory failure; COVID-19; Echocardiography; Haemodynamics; Shock
Substance Nomenclature:: 0 (Cardiotonic Agents)
0 (Vasoconstrictor Agents)
S88TT14065 (Oxygen)
Entry Date(s):: Date Created: 20200812 Date Completed: 20201023 Latest Revision: 20201218
Update Code:: 20240105
PubMed Central ID:: PMC7415168
DOI:: 10.1016/j.accpm.2020.08.001
PMID:: 32781167
: Czasopismo naukowe

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Purpose: To survey haemodynamic monitoring and management practices in intensive care patients with the coronavirus disease 2019 (COVID-19).
Methods: A questionnaire was shared on social networks or via email by the authors and by Anaesthesia and/or Critical Care societies from France, Switzerland, Belgium, Brazil, and Portugal. Intensivists and anaesthetists involved in COVID-19 ICU care were invited to answer 14 questions about haemodynamic monitoring and management.
Results: Globally, 1000 questionnaires were available for analysis. Responses came mainly from Europe (n = 460) and America (n = 434). According to a majority of respondents, COVID-19 ICU patients frequently or very frequently received continuous vasopressor support (56%) and had an echocardiography performed (54%). Echocardiography revealed a normal cardiac function, a hyperdynamic state (43%), hypovolaemia (22%), a left ventricular dysfunction (21%) and a right ventricular dilation (20%). Fluid responsiveness was frequently assessed (84%), mainly using echo (62%), and cardiac output was measured in 69%, mostly with echo as well (53%). Venous oxygen saturation was frequently measured (79%), mostly from a CVC blood sample (94%). Tissue perfusion was assessed biologically (93%) and clinically (63%). Pulmonary oedema was detected and quantified mainly using echo (67%) and chest X-ray (61%).
Conclusion: Our survey confirms that vasopressor support is not uncommon in COVID-19 ICU patients and suggests that different haemodynamic phenotypes may be observed. Ultrasounds were used by many respondents, to assess cardiac function but also to predict fluid responsiveness and quantify pulmonary oedema. Although we observed regional differences, current international guidelines were followed by most respondents.
(Copyright © 2020 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.)

Comment in: Anaesth Crit Care Pain Med. 2020 Oct;39(5):551-552. (PMID: 32896671)

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