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Right over left ventricular end-diastolic area relevance to predict hemodynamic intolerance of high-frequency oscillatory ventilation in patients with severe ARDS

Overview of attention for article published in Annals of Intensive Care, September 2015
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Title
Right over left ventricular end-diastolic area relevance to predict hemodynamic intolerance of high-frequency oscillatory ventilation in patients with severe ARDS
Published in
Annals of Intensive Care, September 2015
DOI 10.1186/s13613-015-0068-6
Pubmed ID
Authors

Lionel Ursulet, Arnaud Roussiaux, Dominique Belcour, Cyril Ferdynus, Bernard-Alex Gauzere, David Vandroux, Julien Jabot

Abstract

High-frequency oscillatory ventilation (HFOV) does not improve the prognosis of ARDS patients despite an improvement in oxygenation. This paradox may partly be explained by HFOV hemodynamic side-effects on right ventricular function. Our goal was to study the link between HFOV and hemodynamic effects and to test if the pre-HFOV right over left ventricular end-diastolic area (RVEDA/LVEDA) ratio, as a simple parameter of afterload-related RV dysfunction, could be used to predict HFOV hemodynamic intolerance in patients with severe ARDS. Twenty-four patients were studied just before and within 3 h of HFOV using transthoracic echocardiography and transpulmonary thermodilution. Before HFOV, the mean PaO2/FiO2 ratio was 89 ± 23. The number of patients with a RVEDA/LVEDA ratio >0.6 significantly increased after HFOV [11 (46 %) vs. 17 (71 %)]. Although HFOV did not significantly decrease the arterial pressure (systolic, diastolic, mean and pulse pressure), it significantly decreased the cardiac index (CI) by 13 ± 18 % and significantly increased the RVEDA/LVEDA ratio by 14 ± 11 %. A significant correlation was observed between pre-HFOV RVEDA/LVEDA ratio and CI diminution after HFOV (r = 0.78; p < 0.0001). A RVEDA/LVEDA ratio superior to 0.6 resulted in a CI decrease >15 % during HFOV with a sensitivity of 80 % (95 % confidence interval 44-98 %) and a specificity of 79 % (confidence interval 49-95 %). The RVEDA/LVEDA ratio measured just before HFOV predicts the hemodynamic intolerance of this technique in patients with severe ARDS. A high ratio under CMV raises questions about the use of HFOV in such patients. ClinicalTrials.gov: NCT01167621.

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Geographical breakdown

Country Count As %
Italy 1 4%
Unknown 23 96%

Demographic breakdown

Readers by professional status Count As %
Librarian 3 13%
Other 3 13%
Researcher 3 13%
Student > Bachelor 2 8%
Student > Postgraduate 2 8%
Other 1 4%
Unknown 10 42%
Readers by discipline Count As %
Medicine and Dentistry 9 38%
Nursing and Health Professions 2 8%
Biochemistry, Genetics and Molecular Biology 1 4%
Agricultural and Biological Sciences 1 4%
Chemistry 1 4%
Other 0 0%
Unknown 10 42%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 September 2015.
All research outputs
#15,295,901
of 22,828,180 outputs
Outputs from Annals of Intensive Care
#824
of 1,043 outputs
Outputs of similar age
#158,562
of 272,396 outputs
Outputs of similar age from Annals of Intensive Care
#8
of 12 outputs
Altmetric has tracked 22,828,180 research outputs across all sources so far. This one is in the 32nd percentile – i.e., 32% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,043 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.6. This one is in the 20th percentile – i.e., 20% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 272,396 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 41st percentile – i.e., 41% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 12 others from the same source and published within six weeks on either side of this one. This one is in the 33rd percentile – i.e., 33% of its contemporaries scored the same or lower than it.