异常右心室心肌性能指数与无急性呼吸窘迫综合征的侵入性通气重症监护病房患者的预后无关——两项随机对照试验的分析

Abnormal Right Ventricular Myocardial Performance Index Is Not Associated With Outcomes in Invasively Ventilated Intensive Care Unit Patients Without Acute Respiratory Distress Syndrome- Analysis of Two RCTs.

作者信息

Pierrakos Charalampos, Geke Algera Anna, Simonis Fabienne, Cherpanath Thomas G V, Lagrand Wim K, Paulus Frederique, Bos Lieuwe D J, Schultz Marcus J

机构信息

Laboratory of Experimental Intensive Care and Anesthesiology (L⋅E⋅I⋅C⋅A), Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, Netherlands.

Department of Intensive Care, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium.

出版信息

Front Cardiovasc Med. 2022 May 31;9:830165. doi: 10.3389/fcvm.2022.830165. eCollection 2022.

DOI:10.3389/fcvm.2022.830165

PMID:35711375

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9197438/

Abstract

BACKGROUND

The objective of the study was to determine the association between right ventricular (RV) myocardial performance index (MPI) and successful liberation from the ventilator and death within 28 days.

METHODS

analysis of 2 ventilation studies in invasively ventilated patients not having ARDS. RV-MPI was collected through transthoracic echocardiography within 24-48 h from the start of invasive ventilation according to the study protocols. RV-MPI ≤ 0.54 was considered normal. The primary endpoint was successful liberation from the ventilator < 28 days; the secondary endpoint was 28-day mortality.

RESULTS

A total of 81 patients underwent transthoracic echocardiography at median 30 (24-42) h after the start of ventilation-in 73 (90%) patients, the RV-MPI could be collected. A total of 56 (77%) patients were successfully liberated from the ventilator < 28 days; A total of 22 (30%) patients had died before or at day 28. A total of 18 (25%) patients had an abnormal RV-MPI. RV-MPI was neither associated with successful liberation from the ventilator within 28 days [HR, 2.2 (95% CI 0.47-10.6); = 0.31] nor with 28-day mortality [HR, 1.56 (95% CI 0.07-34.27) = 0.7].

CONCLUSION

In invasively ventilated critically ill patients without ARDS, an abnormal RV-MPI indicative of RV dysfunction was not associated with time to liberation from invasive ventilation.

摘要

背景

本研究的目的是确定右心室（RV）心肌性能指数（MPI）与28天内成功脱机及死亡之间的关联。

方法

对2项针对无急性呼吸窘迫综合征（ARDS）的有创通气患者的通气研究进行分析。根据研究方案，在有创通气开始后的24 - 48小时内通过经胸超声心动图收集RV - MPI。RV - MPI≤0.54被认为是正常的。主要终点是在28天内成功脱机；次要终点是28天死亡率。

结果

共有81例患者在通气开始后的中位时间30（24 - 42）小时接受了经胸超声心动图检查，其中73例（90%）患者可收集到RV - MPI。共有56例（77%）患者在28天内成功脱机；共有22例（30%）患者在第28天之前或当天死亡。共有18例（25%）患者的RV - MPI异常。RV - MPI与28天内成功脱机无关[风险比（HR），2.2（95%置信区间0.47 - 10.6）；P = 0.31]，也与28天死亡率无关[HR，1.56（95%置信区间0.07 - 34.27）；P = 0.7]。