Echocardiography in Critically-ill Patients With COVID-19 Pneumonia

Study Overview
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Brief Summary
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Critical care echocardiography (CCE) has been widely used since the 10 last years. Covid outbreak leads that many patients with acute respiratory failure were admitted in the ICU. Many of these patients were ventilated and developed ARDS. Some of them developed deep vein thrombosis and pulmonary embolism. Nothing is already described about the cardiac function and the hemodynamics in these patients (how many RV failure, LV systolic dysfunction,...). The echo group of the cardiodynamix section of European society of intensive care medicien (ESICM) aims to promote CCE and evaluate its interest. The objective is to retrospectively enter in an international database all the echo studies done as usual care in these patients to evaluate (i) incidence of RV failure, (ii) incidence of LV systolic function, (iii) incidence of other patterns. Another objective will be to look for any association between some patterns and respiratory strategy, blood gas analysis, systemic hemodynamics. The echo studies were done and will be reported following one of the recent systematic review published by the same group (Huang S et al. AOIC 2020).

Detailed Description
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Multicenter, international observational retrospective study. Patients admitted in the ICU between March 1th and april 26th for a pneumonia related to SARS COV 2 and who had at least one echocardiography during their stay will be included. Analysis will be retrospective in order to report the hemodynamic profile with left ventricular and right ventricular function. Will be also reported the respiratory settings, the central venous presure if available as well as usual parameters of macrocirculation. All data will be reported in RedCap by the University of sydney (https://redcap.sydney.edu.au/).

Official Title
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Echocardiography in Critically-ill Patients With COVID-19 Pneumonia

Conditions
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COVID, Sars-CoV2

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients admitted in the ICU for pneumonia related to SARS COV2 and who had at least 1 critical care echocardiography during the first 28 days. - Exclusion Criteria: Patients who did not have any critical care echocardiography during the first 28 days of the ICU stay.
Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of Left ventricular systolic dysfunction | LV systolic dysfunction is defined as an ejection fraction < 45% | Up to 28 days | 
| Incidence of RV failure | RV failure is defined as RV/LV end-diastolic area > 0.8 | up to 28 days | 
| Incidence of Vasoplegia | Vasoplegia is defined as a normal or supranormal LV ejection fraction without echocarduiographic signs of hypovolemia. | Up to 28 days | 
| Incidence of Hypovolemia | Hypovolemia is defined as inspiratory collaspe of the superior vena cava in ventilated patients or virtual inferior vena cava in spontaneously breathing patients. | Up to 28 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Relation between plateau pressure and RV failure | Plateau pressure and RV size | Up to 28 days | 
| Relation between tidal volume and RV failure | Tidal volume and RV size | Up to 28 days | 
| Relation between PaO2 and RV failure | PaO2, PaO2/FiO2, and RV size | Up to 28 days | 
| Relation between PaCO2 and RV failure | PaCO2 and RV size | Up to 28 days | 
| Relation between PEEP and RV failure | PEEP and RV size | Up to 28 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ICU, COVID, critical care echocardiography, pneumonia