Prognostic Impact of Serial Imaging in Severe Acute Respiratory Distress Syndrome on the Extracorporeal Membrane Oxygenation

Background: The impact of serial imaging on the outcome of ICU patients has not been studied specifically in patients with high illness severity. Methods: The authors sought a relationship between the numbers of antero-posterior supine chest X-rays (CXR), computed tomography (CT) examinations, and o...

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Bibliographic Details
Published in:Journal of clinical medicine 2023-10, Vol.12 (19), p.6367
Main Authors: Balik, Martin, Maly, Michal, Huptych, Michal, Mokotedi, Masego Candy, Lambert, Lukas
Format: Article
Language:English
Subjects:
Abdomen
Acute respiratory distress syndrome
Blood oxygenation, Extracorporeal
Body mass index
Cardiac arrest
Cardiopulmonary resuscitation
Care and treatment
Clinical medicine
Contrast agents
COVID-19
CPR
CT imaging
Extracorporeal membrane oxygenation
Illnesses
Intensive care
Length of stay
Medical imaging
Patient outcomes
Patients
Prognosis
Regression analysis
Ultrasonic imaging
Ventilators
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Summary:Background: The impact of serial imaging on the outcome of ICU patients has not been studied specifically in patients with high illness severity. Methods: The authors sought a relationship between the numbers of antero-posterior supine chest X-rays (CXR), computed tomography (CT) examinations, and outcome in a cohort of 292 patients with severe COVID-19 ARDS collected over 24 months in a high-volume ECMO center with established ultrasound and echocardiographic diagnostics. Of the patients, 172 (59%) were obese or morbidly obese, and 119 (41%) were treated with ECMO. Results: The median number of CXRs was eight per 14 days of the length of stay in the ICU. The CXR rate was not related to ICU survival (p = 0.37). Patients required CT scanning in 26.5% of cases, with no relationship to the outcome except for the better ICU survival of the ECMO patients without a need for a CT scan (p = 0.01). The odds ratio for survival associated with ordering a CT scan in an ECMO patient was 0.48, p = 0.01. The calculated savings for not routinely requesting a whole-body CT scan in every patient were 98.685 EUR/24 months. Conclusions: Serial imaging does not impact the survival rates of patients with severe ARDS. Extracorporeal membrane oxygenation patients who did not need CT scanning had significantly better ICU outcomes.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm12196367