Serial Assessment of Myocardial Injury Markers in Mechanically Ventilated Patients With SARS-CoV-2 (from the Prospective MaastrICCht Cohort)

Ghossein, Mohammed A.; Driessen, Rob; Rosmalen, Frank van; Sels, Jan-Willem; Delnoij, Thijs; Geyik, Z.; Mingels, Alma M.A.; Stipdonk, Antonius M.W. van; Prinzen, Frits W.; Ghossein‐Doha, Chahinda; Kuijk, Sander M J van; Horst, Iwan C C van der; Vernooy, Kevin; Bussel, Bas C.T. van

doi:10.1016/j.amjcard.2022.01.030

Cited by 12 publications

(9 citation statements)

References 28 publications

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“…Our finding of adverse COVID-19 outcomes associated with myocardial injury based on serial high-sensitivity cardiac troponin assessment is in line with existing evidence [21] , [22] , [23] , [24] and underscores the value of serial cardiac troponin measurements in patients with COVID-19. However, current evidence is limited by the definitions of myocardial injury employed, lack of data on serial testing and thereby dynamic cardiac troponin changes, use of inconsistent sampling intervals, and use of non-high-sensitivity assays [12] .…”

Section: Discussionsupporting

confidence: 89%

“…Besides isolated myocardial injury or type 2 myocardial infarction, such elevations may be indicative of myocarditis or type 1 myocardial infarction and may further be associated with both increased disease severity and mortality [10] , [11] , [12] , [13] , [14] , [15] . While serial cardiac troponin testing plays crucial diagnostic and prognostic roles among patients presenting with acute-onset chest pain [16] , [17] , [18] , [19] , [20] , evolving data also suggest that serial troponin assessment may improve prognostic stratification in patients with COVID-19 [21] , [22] , [23] , [24] .…”

Section: Introductionmentioning

confidence: 99%

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Prognostic implications of serial high-sensitivity cardiac troponin testing among patients with COVID-19: A Danish nationwide registry-based cohort study

Polcwiartek

Krogager

Andersen

et al. 2022

American Heart Journal Plus: Cardiology Research and Practice

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Prognostic implications of serial high-sensitivity cardiac troponin testing among patients with COVID-19: A Danish nationwide registry-based cohort study

Polcwiartek

Krogager

Andersen

et al. 2022

American Heart Journal Plus: Cardiology Research and Practice

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“…The Maastricht Intensive Care COVID (MaastrICCht) cohort study design has been described more extensively elsewhere [33][34][35][36] This study included all participants with respiratory insu ciency requiring mechanical ventilation and at least one positive PCR test for SARS-CoV-2 and/or a chest CT scan strongly suggestive of SARS-CoV-2 infection, based on a CORADS-score of 4-5 37 . Participants were followed from the moment of intubation until the primary outcome (death during ICU admission or discharge from the ICU).…”

Section: Study Design and Populationmentioning

confidence: 99%

“…This makes patients at inclusion to be assumed at similar time-points of disease and severity during their COVID-19 disease, i.e., an inception cohort. In addition, this allows us to take all observations into account over time, also if a patient is transported after intubation from another ICU, facilitating the investigation of the development of variables over time 34,35,40 .…”

Section: Study Design and Populationmentioning

confidence: 99%

Hyperglycemia and glucose variability are associated with worse survival in mechanically ventilated COVID-19 patients: the prospective Maastricht Intensive Care Covid Cohort

Herpt

Rosmalen

Hulsewé

et al. 2023

Preprint

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Data on hyperglycemia and glucose variability in relation to diabetes mellitus, either known or unknown in ICU-setting in COVID-19, are scarce. We prospectively studied daily glucose variables and mortality in strata of diabetes mellitus and glycosylated hemoglobin among mechanically ventilated COVID-19 patients. We used linear-mixed effect models in mechanically ventilated COVID-19 patients to investigate mean and maximum difference in glucose concentration per day over time. We compared ICU survivors and non-survivors and tested for effect-modification by pandemic wave 1 and 2, diabetes mellitus, and admission HbA1c. Among 232 mechanically ventilated COVID-19 patients, 21.1% had known diabetes mellitus, whereas 16.9% in wave 2 had unknown diabetes mellitus. Non-survivors had higher mean glucose concentrations (ß 0.62 mmol/l; 95%CI 0.20–1.06; P = 0.004) and higher maximum differences in glucose concentrations per day (ß 0.85 mmol/l; 95%CI 0.37–1.33; P = 0.001). Effect modification by wave, history of diabetes mellitus and admission HbA1c in associations between glucose and survival was not present. Effect of higher mean glucose concentrations was modified by pandemic wave (wave 1 (ß 0.74; 95% CI 0.24–1.23) mmol/l vs. wave 2 ß 0.37 (95%CI 0.25–0.98) mmol/l). Hyperglycemia and glucose variability are associated with mortality in mechanically ventilated COVID-19 patients irrespective of the presence of diabetes mellitus.

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“…Furthermore, Troponin-T and Troponin-I could have prognostic value in pulmonary diseases such as pneumonia and chronic obstructive pulmonary disease 40 . A serial assessment can identify factors predicting cardio-circulatory damage or mortality in ECMO but with a lower prognostic value compared to lactate 39,41 .…”

Section: Bnp Nt-pro-bnp and Troponinmentioning

confidence: 99%

Hemodynamic Monitoring during Veno-Venous Extracorporeal Membrane Oxygenation: A scoping review

Lorusso

Piero

Mariani

et al. 2022

Preprint

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Background Optimizing cardiovascular monitoring and support during veno-venous Extracorporeal Membrane Oxygenation (V-V ECMO) is essential to ensure overall adequacy of end-organ perfusion and proper titration of extracorporeal support. Despite an increasing V-V ECMO use, guidelines on monitoring of cardiovascular function during mechanical support are lacking, with current approaches mostly based on clinicians’ experience rather than evidence-based recommendations. This scoping review focused on basic and more advance methods for hemodynamic monitoring during V-V ECMO in adult patients. Methods Databases (PubMed, EMBASE and Cochrane CENTRAL) and reference lists of relevant articles were searched from inception until November 2021. We included studies of any methodology that addressed the a priori key questions relating to hemodynamic monitoring during respiratory extracorporeal support. Results Overall, 465 articles were screened, and 106 articles were included for detailed analysis. Protocolized hemodynamic monitoring and lines of evidence were not found and in particular the main body of the literature was concentrated on cardiocirculatory support. Tools recommendations regarding the available monitoring techniques are described, with an overview of basic, prognostic/diagnostic and advanced methods. While these strategy does not influence time to wean, the application of care bundles and multidisciplinary team approaches could be associated with reduced complications and improved outcomes. Conclusions Patients undergoing respiratory support with V-V ECMO experience complex interactions among the patient’s and extracorporeal circulation, individual’s lung function and related circulatory changes. The critical needs for multidisciplinary teams, specified trainings, new research directions, and an accurate monitoring aiming to improve outcomes are essential for optimal decision-making.

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Serial Assessment of Myocardial Injury Markers in Mechanically Ventilated Patients With SARS-CoV-2 (from the Prospective MaastrICCht Cohort)

Cited by 12 publications

References 28 publications

Prognostic implications of serial high-sensitivity cardiac troponin testing among patients with COVID-19: A Danish nationwide registry-based cohort study

Prognostic implications of serial high-sensitivity cardiac troponin testing among patients with COVID-19: A Danish nationwide registry-based cohort study

Hyperglycemia and glucose variability are associated with worse survival in mechanically ventilated COVID-19 patients: the prospective Maastricht Intensive Care Covid Cohort

Hemodynamic Monitoring during Veno-Venous Extracorporeal Membrane Oxygenation: A scoping review

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