The association between pulmonary artery systolic pressure and
mechanical ventilator weaning success in critically ill patients with
COVID-19.
Abstract
To explore the association between pulmonary artery systolic pressure
(PASP) and success to wean from mechanical ventilation in COVID-19
patients.Thirty-four critically ill COVID-19 patients who had been
placed on ventilator support were enrolled in this retrospective study
and were divided into two groups: the weaning success group (group I)
and the weaning failure group (group II). Physical examination,
echocardiography, and routine laboratory test data were collected. The
levels of troponin I, myoglobin, interleukin 6, and D-dimer were
significantly lower in group I than in group II. The interventricular
septum end-diastolic thickness (IVSd) was thicker (14.00
[13.50‒15.00] mm) and the PASP was higher (61.63 ± 13.53 mmHg) in
group II. Logistic regression analysis showed that D-dimer and IVSd were
factors associated with ventilator weaning. The odds ratio (OR) of
D-dimer was 0.81 (95% CI 0.69‒0.95) and the OR of IVSd was 0.16 (95%
CI 0.045‒0.59). Cox analysis revealed that the adjusted hazard ratio
(HR) for a 1-mmHg increase in PASP was 0.94 (95% CI 0.90‒0.97) for
weaning events (P < 0.001). PASP was negatively correlated
with the PaO2:FiO2 (r = -0.48, P < 0.01). A receiver operating
characteristic curve showed that the best cutoff value of PASP for
ventilator weaning was 39.50 mmHg, with a sensitivity of 100% and a
specificity of 96.15% PASP was an independent risk factor for the
difficulty of weaning severely ill COVID-19 patients off mechanical
ventilation. PASP can be used as one of the indicators for evaluating
the condition of COVID-19 patients.