Computed tomography evaluation of diaphragm alterations in 20 critically ill COVID-19 positive patients

Acta Medica Marisiensis

article

Oana Elena Branea¹  AnaMaria Romina Budeanu²  Răzvan Gabriel Budeanu³  Adrian Ștefan Chiuzan⁴  Ioana Lăcrămioara Nazaret⁵  Sanda Maria Copotoiu¹  Alexandra Elena Lazăr¹ 

[1]Department of Anesthesia and Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science

[2]Department of Anesthesia and Intensive Care, Emergency Clinical County Hospital of Târgu Mureș

[3]Department of Radiology, Emergency Clinical County Hospital of Târgu Mureș

[4]Department of Radiology, Emergency Clinical County Hospital of Bistrița

[5]Department of Anesthesia and Intensive Care, Emergency Clinical County Hospital of Piatra Neamț

关键词: diaphragm changes;    chest computed tomography;    critically ill;    COVID-19;   

DOI  :  10.2478/amma-2022-0014

来源: Walter de Gruyter GmbH

【 摘 要 】

Objective: Diaphragmatic dysfunctions are multiple and critical illnesses often lead to the muscular atrophy that affects respiratory and peripheral muscles. The primary objective was to investigate diaphragm thickness in hospitalized patients. Secondary objectives were to assess clinical evolution and outcome. Methods: In a mean time period of 7.9 days, two different chest computed tomographies were used in order to examine diaphragm alterations of right and left diaphragm in 20 critically ill patients tested Real-Time Polymerase Chain Reaction positive to Severe Acute Respiratory Syndrome Coronavirus-2. Patients were divided in two groups (one group <5% decrease in diaphragm thickness and another group ≥5% decrease in diaphragm thickness). Results: Results showed that patients presented low 10 years predicted survival rate (Charlson Comorbidity Index > 7.7±3.08), marked inflammatory status (C-Reactive Protein = 98.22±73.35, Interleukine-6 = 168.31±255.28), high physiologic stress level (Neutrophil/Lymphocyte Ratio = 31.27±30.45), respectively altered acid-base equilibrium. Half of the investigated patients had decrease in diaphragm thickness by at least 5% (right diaphragm = −7.83%±11.11%, left diaphragm = −5.57%±10.63%). There were no statistically significant differences between those with decrease of diaphragm thickness and those without diaphragm thickness, regarding length of stay in Intensive Care Unit and in hospital, inflammatory markers, and acid-base disorders.

【 授权许可】

Unknown