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

• 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
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12196367

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.