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COVID-19 和非 COVID-19 导致的急性呼吸窘迫综合征患者的计算机断层扫描定量分析：一项病例对照研究。

Quantitative-analysis of computed tomography in COVID-19 and non COVID-19 ARDS patients: A case-control study.

机构信息

Service de Médecine Intensive Réanimation, Hôpital De La Croix Rousse, Hospices Civils de Lyon, 93 grande rue de la Croix-Rousse, 69004 Lyon, France.

Service de Médecine Intensive Réanimation, Hôpital De La Croix Rousse, Hospices Civils de Lyon, 93 grande rue de la Croix-Rousse, 69004 Lyon, France; Université de Lyon, Université Claude Bernard Lyon 1, INSA-Lyon, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, 7 Avenue Jean Capelle, 69621 Villeurbanne, France.

出版信息

J Crit Care. 2020 Dec;60:169-176. doi: 10.1016/j.jcrc.2020.08.006. Epub 2020 Aug 13.

DOI:10.1016/j.jcrc.2020.08.006
PMID:32854088
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7423516/
Abstract

PURPOSE

The aim of this study was to assess whether the computed tomography (CT) features of COVID-19 (COVID+) ARDS differ from those of non-COVID-19 (COVID-) ARDS patients.

MATERIALS AND METHODS

The study is a single-center prospective observational study performed on adults with ARDS onset ≤72 h and a PaO/FiO ≤ 200 mmHg. CT scans were acquired at PEEP set using a PEEP-FiO table with VT adjusted to 6 ml/kg predicted body weight.

RESULTS

22 patients were included, of whom 13 presented with COVID-19 ARDS. Lung weight was significantly higher in COVID- patients, but all COVID+ patients presented supranormal lung weight values. Noninflated lung tissue was significantly higher in COVID- patients (36 ± 14% vs. 26 ± 15% of total lung weight at end-expiration, p < 0.01). Tidal recruitment was significantly higher in COVID- patients (20 ± 12 vs. 9 ± 11% of VT, p < 0.05). Lung density histograms of 5 COVID+ patients with high elastance (type H) were similar to those of COVID- patients, while those of the 8 COVID+ patients with normal elastance (type L) displayed higher aerated lung fraction.

摘要

目的

本研究旨在评估 COVID-19（COVID+）ARDS 的 CT 特征是否与非 COVID-19（COVID-）ARDS 患者的 CT 特征不同。

材料和方法

本研究是一项单中心前瞻性观察研究，纳入了ARDS 发病时间≤72 小时且 PaO/FiO≤200mmHg 的成人患者。在呼气末平台压力（PEEP）设定时采集 CT 扫描，使用 PEEP-FiO 表，VT 调整至预测体重的 6ml/kg。

结果

共纳入 22 名患者，其中 13 名患者患有 COVID-19 ARDS。COVID+患者的肺重量明显更高，但所有 COVID+患者的肺重量均超过正常值。非膨胀肺组织在 COVID-患者中明显更高（呼气末时占总肺重量的 36±14%比 26±15%，p<0.01）。COVID-患者的潮气量募集明显更高（20±12%比 9±11%，p<0.05）。5 名具有高顺应性（H 型）的 COVID+患者的肺密度直方图与 COVID-患者相似，而 8 名具有正常顺应性（L 型）的 COVID+患者的充气肺分数更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de70/7423516/eb0b025c0516/gr4_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de70/7423516/3e0cb6e1ba1e/ga1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de70/7423516/3b653626d50d/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de70/7423516/4373482bcfc0/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de70/7423516/4e47860011ff/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de70/7423516/eb0b025c0516/gr4_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de70/7423516/3e0cb6e1ba1e/ga1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de70/7423516/3b653626d50d/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de70/7423516/4373482bcfc0/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de70/7423516/4e47860011ff/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de70/7423516/eb0b025c0516/gr4_lrg.jpg

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