Abstract
Background: Right ventricular (RV) dysfunction develops frequently in patients with acute respiratory distress syndrome and is associated with short-term mortality. However, the incidence of long-term RV dysfunction and risk factor associated with it in ARDS survivors remains unknown. The aim of the study was to assess the prevalence and risk factors of long-term RV dysfunction in ARDS survivors.
Method: This is a single-center retrospective cohort study including adult patients with ARDS admitted to the medical intensive care unit (MICU) at Cleveland Clinic between 1/1/2010–12/31/2017. We included patients with ARDS, who had echocardiography performed within 72 hours of MICU admission, survived 90 days from onset of ARDS with post-discharge echocardiography performed between 30-365 days after hospital discharge. RV dysfunction was defined based on the American Society of Echocardiography guidelines.
Results: Of the 689 patients who were admitted to Cleveland Clinic for ARDS during the study period, 67 (14.07%) patients met the study criteria. A total of 34 patients (50. 7%) had RV dysfunction on post-discharge echocardiogram. In the multivariate logistic regression analyses, the incidence of long-term RV dysfunction was associated only with RVEDA/LVEDA [odds ratio (OR): 589, 95% confidence interval (CI): 71.17-48,400, p=0.005].
Conclusion: More than half of ARDS survivors had developed long-term RV dysfunction at post-discharge echocardiogram. Increased ratio of right-to-left ventricular end-diastolic area (RVEDA/LVEDA) ratio during ARDS was the significantly associated with development of long-term RV dysfunction in ARDS survivors.
Trial registration: This study was approved by the Institutional Review Committee of Cleveland Clinic (IRB#19-1200) .
Continuous long‐term wireless measurement of right ventricular pressures and estimated diastolic pulmonary artery pressure in patients with severe COVID‐19 acute respiratory distress syndrome
