PDF(Pubmed)
Abstract：
UNASSIGNED: The effects of obesity on pulmonary gas and blood distribution in patients with acute respiratory failure remain unknown. Dual-energy computed tomography (DECT) is a X-ray-based method used to study regional distribution of gas and blood within the lung. We hypothesized that 1) regional gas/blood mismatch can be quantified by DECT; 2) obesity influences the global and regional distribution of pulmonary gas and blood; 3) regardless of ventilation modality (invasive vs. non-invasive ventilation), patients\' body mass index (BMI) has an impact on pulmonary gas/blood mismatch.
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.
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.
摘要：
■肥胖对急性呼吸衰竭患者肺气和血液分布的影响尚不清楚。双能计算机断层扫描（DECT）是一种基于X射线的方法，用于研究肺部气体和血液的区域分布。我们假设1)可以通过DECT量化区域气体/血液不匹配；2)肥胖影响肺气和血液的全球和区域分布；3)无论通气方式(侵入性与无创通气），患者体重指数(BMI)对肺气体/血液不匹配有影响。
■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。
■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。
