Functional respiratory imaging identifies redistribution of pulmonary blood flow in patients with COVID-19.
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Peer-reviewed
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Abstract
An increasing observation is that some patients with COVID-19 have normal lung compliance but significant hypoxaemia different from typical acute respiratory distress syndrome (ARDS). We hypothesised that changes in pulmonary blood distribution may be partially responsible and used functional respiratory imaging on CT scans to calculate pulmonary blood volume. We found that patients with COVID-19 had significantly reduced blood volume in the smaller calibre blood vessels (here defined as <5 mm2 cross-sectional area) compared with matched ARDS patients and healthy controls. This suggests that using high levels of PEEP may not alone be enough to oxygenate these patients and that additional management strategies may be needed.
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Keywords
ARDS, MRI, critical care, imaging/CT, COVID-19, Humans, Lung, Lung Compliance, Pandemics, Pulmonary Circulation, Respiratory Function Tests, Respiratory Mechanics, Retrospective Studies, SARS-CoV-2, Tomography, X-Ray Computed
Journal Title
Thorax
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0040-6376
1468-3296
1468-3296
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Publisher
BMJ