这项研究的目的是评估COVID-19(COVID-)ARDS的计算机断层扫描(CT)特征是否与非COVID-19(COVID-)ARDS患者的CT特征不同。
本研究是对ARDS发病≤72小时且PaO2/FiO2≤200mmHg的成人进行的单中心前瞻性观察性研究。使用PEEP-FiO2表在PEEP设置下获得CT扫描,其中VT调整至6ml/kg预测体重。
纳入22例患者,其中13人出现COVID-19ARDS。COVID患者的肺重量明显更高,但所有COVID+患者的肺重量值均处于正常水平。COVID患者的非充气肺组织明显更高(36±14%vs.呼气末肺总重量的26±15%,p<0.01)。COVID患者的潮汐募集明显更高(20±12vs.室性心动过速的9±11%,p<0.05)。5例高弹性(H型)COVID患者的肺密度直方图与COVID患者相似,而8例弹性正常(L型)的COVID+患者显示较高的充气肺分数。
The aim of this study was to assess whether the computed tomography (CT) features of COVID-19 (COVID+) ARDS differ from those of non-COVID-19 (COVID-) ARDS patients.
The study is a single-center prospective observational study performed on adults with ARDS onset ≤72 h and a PaO2/FiO2 ≤ 200 mmHg. CT scans were acquired at PEEP set using a PEEP-FiO2 table with VT adjusted to 6 ml/kg predicted body weight.
22 patients were included, of whom 13 presented with COVID-19 ARDS. Lung weight was significantly higher in COVID- patients, but all COVID+ patients presented supranormal lung weight values. Noninflated lung tissue was significantly higher in COVID- patients (36 ± 14% vs. 26 ± 15% of total lung weight at end-expiration, p < 0.01). Tidal recruitment was significantly higher in COVID- patients (20 ± 12 vs. 9 ± 11% of VT, p < 0.05). Lung density histograms of 5 COVID+ patients with high elastance (type H) were similar to those of COVID- patients, while those of the 8 COVID+ patients with normal elastance (type L) displayed higher aerated lung fraction.