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. 2020 Aug 6;10(1):108.
doi: 10.1186/s13613-020-00726-z.

Is hypoxemia explained by intracardiac or intrapulmonary shunt in COVID-19-related acute respiratory distress syndrome?

Paul Masi  1   2 , François Bagate  3   4 , Thomas d'Humières  5   6 , Lara Al-Assaad  5 , Laure Abou Chakra  5 , Genevieve Derumeaux  5   6 , Armand Mekontso Dessap  3   4
Affiliations

Is hypoxemia explained by intracardiac or intrapulmonary shunt in COVID-19-related acute respiratory distress syndrome?

Paul Masi et al. Ann Intensive Care. .

Abstract

Hypoxemia is the main feature of COVID-19-related acute respiratory distress syndrome (C-ARDS), but its underlying mechanisms are debated, especially in patients with low respiratory system elastance (Ers). We assessed 60 critically ill patients hospitalized in our intensive care unit for C-ARDS. We used contrast transthoracic echocardiography to assess patent foramen ovale (PFO) shunt and transpulmonary bubble transit (TPBT). The median Ers was 32 cmH2O/L. PFO shunt was detected in six (10%) patients and TPBT in 12 (20%) patients. PFO shunt and TPBT were similar in patients with higher or lower Ers. In conclusion, PFO and TPBT do not seem to be the main drivers of hypoxemia in C-ARDS, especially in patients with lower Ers.

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Conflict of interest statement

The authors declare that they have no competing interests.

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