CT-derived measurements of pulmonary blood volume in small vessels and the need for supplemental oxygen in COVID-19 patients

Background: Throughout the COVID-19 pandemic, a portion of those affected have evolved towards acute hypoxic respiratory failure. Initially, this was hypothesized to result from acute lung injury leading to acute respiratory distress syndrome (ARDS). In previous research, a novel quantitative CT post-processing techniques was described to quantify the volume of blood contained within pulmonary blood vessels of a given size. Hypothesized that patients with lower BV5 blood flow, would have higher supplemental oxygen need and less favorable arterial blood gas profiles. Methods: From the initial data analysis, 111 hospitalized COVID-19 patients were retrospectively selected based on the availability of CT scans of the lungs with slice thickness 1.5 mm or less, as well as PCR-confirmed SARS-CoV2 infection. 3D reconstructions of the lungs and pulmonary vasculature were created. Further analysis was performed on 50 patients. Patients were divided into groups based on their need for oxygen at the time of CT scan acquisition. Results: 18 out of 50 patients needed >2 L/min supplemental oxygen and this group demonstrated a significantly lower median percentage of total blood flow in the BV5 vessels compared to the 32 patients who needed < 2 L/min supplemental oxygen (41.61% vs 46.89%, p=0.023). Both groups had significantly less blood as a proportion in BV5 vessels compared to healthy volunteers. Conclusion: This data is consistent with the hypothesis that reduced blood volume within small (BV5) pulmonary vessels is associated with higher need for supplemental oxygen and more severe gas exchange anomalies in COVID-19 infections.

Jaar van publicatie:2022

Trefwoorden:A1 Journal article

Toegankelijkheid:Open