UNASSIGNED: This single-centre prospective observational study enrolled 118 hypoxic COVID-19 patients (92 male) in need of respiratory support and intensive care who underwent DECT. The cohort was divided into three groups according to BMI: 1. BMI<25 kg/m2 (non-obese), 2. BMI = 25-40 kg/m2 (overweight to obese), and 3. BMI>40 kg/m2 (morbidly obese). Gravitational analysis of Hounsfield unit distribution of gas and blood was derived from DECT and used to calculate regional gas/blood mismatch. A sensitivity analysis was performed to investigate the influence of the chosen ventilatory modality and BMI on gas/blood mismatch and adjust for other possible confounders (i.e., age and sex).
UNASSIGNED: 1) Regional pulmonary distribution of gas and blood and their mismatch were quantified using DECT imaging. 2) The BMI>40 kg/m2 group had less hyperinflation in the non-dependent regions and more lung collapse in the dependent regions compared to the other BMI groups. In morbidly obese patients, gas and blood were more evenly distributed; therefore, the mismatch was lower than in other patients (30% vs. 36%, p < 0.05). 3) An increase in BMI of 5 kg/m2 was associated with a decrease in mismatch of 3.3% (CI: 3.67% to -2.93%, p < 0.05). Neither the ventilatory modality nor age and sex affected the gas/blood mismatch (p > 0.05).
UNASSIGNED: 1) In a hypoxic COVID-19 population needing intensive care, pulmonary gas/blood mismatch can be quantified at a global and regional level using DECT. 2) Obesity influences the global and regional distribution of gas and blood within the lung, and BMI>40 kg/m2 improves pulmonary gas/blood mismatch. 3) This is true regardless of the ventilatory mode and other possible confounders, i.e., age and sex.
UNASSIGNED: Clinicaltrials.gov, identifier NCT04316884, NCT04474249.
■这项单中心前瞻性观察性研究纳入了118例需要呼吸支持和重症监护的COVID-19低氧患者(92例男性),这些患者接受了DECT。根据BMI将该队列分为三组:1。BMI<25kg/m2(非肥胖),2.BMI=25-40kg/m2(超重至肥胖),and3.BMI>40kg/m2(病态肥胖)。气体和血液的Hounsfield单位分布的重力分析来自DECT,用于计算区域气体/血液不匹配。进行了敏感性分析,以调查所选择的通气方式和BMI对气/血不匹配的影响,并调整其他可能的混杂因素(即,年龄和性别)。
■1)使用DECT成像定量气体和血液的局部肺部分布及其不匹配。2)与其他BMI组相比,BMI>40kg/m2组在非依赖区域的过度充气较少,而在依赖区域的肺塌陷较多。在病态肥胖患者中,气体和血液分布更均匀;因此,失配低于其他患者(30%vs.36%,p<0.05)。3)BMI增加5kg/m2与失配减少3.3%有关(CI:3.67%至-2.93%,p<0.05)。通气方式或年龄和性别均不影响气/血不匹配(p>0.05)。
■1)在需要重症监护的缺氧COVID-19人群中,可以使用DECT在全球和区域水平上量化肺气/血不匹配。2)肥胖影响肺内气体和血液的全球和区域分布,和BMI>40kg/m2改善肺气/血不匹配。3)无论通气模式和其他可能的混杂因素如何,这都是正确的,即,年龄和性别
■Clinicaltrials.gov,标识符NCT04316884、NCT04474249。