COVID-19 and haemodynamic failure: a point of view on mechanisms and treatment

Jasiński, Tomasz; Stefaniak, Jan

doi:10.5114/ait.2020.101813

Cited by 7 publications

(10 citation statements)

References 112 publications

(122 reference statements)

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“…Universally, the mortality of critically ill patients with COVID-19 is higher than that of other critically ill patients [53,54]. A main cause for this difference is the characteristics of the SARS-CoV-2 infection, which can rapidly affect other organs including the cardiovascular system [55]. However, there are no specific guidelines on the hemodynamic support of COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

Association of vasopressors with mortality in critically ill patients with COVID-19: A systematic review and meta-analysis

Mermiri

Mavrovounis

Laou

et al. 2022

Preprint

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Purpose: The effect of vasopressors on mortality of critically ill patients with COVID-19 has not been studied extensively. Methods: A systematic search of PubMed, Scopus, and clinicaltrials.gov was conducted for relevant articles until January 2022. Eligibility criteria were randomized controlled and non-randomized trials. The primary outcome was all-cause mortality at 28 days or 30 days. The quality of studies was assessed using the MINORS tool. Paired meta-analysis was used to estimate the pooled risk ratios along with their 95% Confidence Interval. Results: In total, 33 studies were included. Twenty-one studies with a total population of 7900 individuals provided data on mortality. Patients who received vasopressors were statistically significantly more likely to die compared to those who did not receive vasopressor therapy [RR (95%CI): 4.26 (3.15, 5.76); p<0.001]. This result remained statistically significant regardless of the in-hospital setting. In-hospital and 30-day mortality were statistically significantly higher in patients who received vasopressors [RR (95%CI): 4.60 (2.47, 8.55); p<0.001 and RR (95%CI): 2.97 (1.72, 5.14); p<0.001, respectively]. Four studies provided data on specific vasopressors; the highest mortality rate was observed in patients treated with vasopressin or epinephrine, while patients receiving angiotensin-II as a sole or second-line vasopressor agent had the lowest mortality rate. Also, analysis of 10 studies with a total population of 3519 individuals revealed that patients who received vasopressors were statistically significantly more likely to experience acute kidney injury [RR (95%CI): 3.17 (2.21, 4.54); p<0.001]. Conclusion: Vasopressors have detrimental effect on survival of critically ill patients with COVID-19.

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Section: Discussionmentioning

confidence: 99%

Association of vasopressors with mortality in critically ill patients with COVID-19: A systematic review and meta-analysis

Mermiri

Mavrovounis

Laou

et al. 2022

Preprint

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“… 2 Potential mechanisms by which COVID-19 may impact myocardial function include myocarditis, 10 effects of inflammatory cytokines, MI, and microcirculatory dysfunction with the potential for ischemia. 1 , 3 Several patients had pulmonary emboli and pericardial tamponade, which have also been reported as complications of COVID. 2 , 11 …”

Section: Discussionmentioning

confidence: 97%

“…Some of that shock is cardiogenic; potential mechanisms of myocardial injury in COVID-19 include direct injury from viral infection, consequences of the immune response to COVID, ischemia or infarction, dysregulation of the renin-angiotensin system, and endothelial dysfunction, which appears to be most prominent in the microcirculation. 1 , 2 , 3 In other patients, shock may be hypovolemic, obstructive, or distributive. The proportion of the various potential etiologies of shock in critically ill patients with COVID-19 is currently unknown.…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic Profiles of Shock in Patients With COVID-19

Hollenberg

Safi

Parrillo

et al. 2021

The American Journal of Cardiology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…However, it must be kept in mind that artery cannulation with bore catheters poses some kind of risk. Type of monitoring should be tailored to the patient’s condition and also, as it is especially very important in COVID-19 patients, to the medical staff safety [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

The Incidence of Radial Artery Occlusion in Critically Ill Patients after Cannulation with a Long Catheter

Wujtewicz

Regent

Marszałek-Ratnicka

et al. 2021

JCM

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Cardiac output monitoring is a common practice in critically ill patients. The PiCCO (pulse index continuous cardiac output) method requires artery cannulation. According to the manufacturer, the cannula in the radial artery should be removed after three days. However, longer monitoring is sometimes necessary. The aim of this study was to assess the incidence of radial artery occlusion (RAO) after three days of cannulation and to check whether five-day cannulation is related to a higher occlusion rate. An additional assessment was made to verify the presence of occlusion three, fourteen and thirty days after decannulation. The PiCCO cannula was inserted into the radial artery after the Barbeau test and Doppler assessment of blood flow. It was left for three or five days. Doppler was performed immediately after its removal and at three, fourteen and thirty days following decannulation. Thirty-seven patients were randomly assigned for three or five days of cannulation, and twenty-three of them were eligible for further analysis. RAO was found in thirteen (56.5%) patients. No statistical difference was found between the RAO rate for three and five day cannulations (p = 0.402). The incidence of RAO was lower when the right radial artery was cannulated (p = 0.022; OR 0.129). Radial artery cannulation with a PiCCO catheter poses a risk of RAO. However, the incidence of prolonged cannulation appeared to not increase the risk of artery occlusion. ClinicalTrials.gov ID NCT02695407.

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COVID-19 and haemodynamic failure: a point of view on mechanisms and treatment

Cited by 7 publications

References 112 publications

Association of vasopressors with mortality in critically ill patients with COVID-19: A systematic review and meta-analysis

Association of vasopressors with mortality in critically ill patients with COVID-19: A systematic review and meta-analysis

Hemodynamic Profiles of Shock in Patients With COVID-19

The Incidence of Radial Artery Occlusion in Critically Ill Patients after Cannulation with a Long Catheter

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