Role of Alveolar-Arterial Difference in Estimation of Extravascular Lung Water in COVID-19-Related ARDS
| Authors | |
|---|---|
| Year of publication | 2024 |
| Type | Article in Periodical |
| Magazine / Source | RESPIRATORY CARE |
| MU Faculty or unit | |
| Citation | |
| web | https://www.liebertpub.com/doi/10.4187/respcare.11804 |
| Doi | http://dx.doi.org/10.4187/respcare.11804 |
| Keywords | alveolar gas equation; extravascular lung water index; ARDS; hypoxemia; end-tidal O2; COVID-19; alveolar-arterial difference |
| Description | BACKGROUND: The dominant feature of COVID-19-associated ARDS is gas exchange impairment. Extravascular lung water index is a surrogate for lung edema and reflects the level of alveolocapillary disruption. The primary aim was the prediction of extravascular lung water index by the alveolar-arterial oxygen difference. The secondary aims were in determining the relationship between the extravascular lung water index and other oxygenation parameters, the F-IO2, end-tidal oxygen concentration, pulmonary oxygen gradient (F-IO2 minus end-tidal oxygen concentration), and P-aO2. METHODS: This observational prospective single-center study was performed at the Department of Anaesthesiology and Intensive Care, The University Hospital in Ostrava, The Czech Republic, during the COVID-19 pandemic, from March 20, 2020, until May 24, 2021. RESULTS: The relationship between the extravascular lung water index and alveolar-arterial oxygen difference showed only a mild-to-moderate correlation (r = 0.33, P < .001). Other extravascular lung water index correlations were as follows: F-IO2 (r = 0.33, P < .001), end-tidal oxygen concentration (r = 0.26, P = .0032), F-IO2 minus end-tidal oxygen concentration (r = 0.15, P = .0624), and P-aO2 (r = -0.15, P = .01). CONCLUSIONS: The alveolar-arterial oxygen difference does not reliably correlate with the extravascular lung water index and the degree of lung edema in COVID-19-associated ARDS. |
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