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Abstract
BACKGROUND: The dominant feature of COVID-19-associated ARDS is gas exchange impairment. Extravascular lung water index is a surrogate for lung edema and reflects the level of alveolocapillary disruption. The primary aim was the prediction of extravascular lung water index by the alveolar-arterial oxygen difference. The secondary aims were in determining the relationship between the extravascular lung water index and other oxygenation parameters, the 
, end-tidal oxygen concentration, pulmonary oxygen gradient (
minus end-tidal oxygen concentration), and 
.
METHODS: This observational prospective single-center study was performed at the Department of Anaesthesiology and Intensive Care, The University Hospital in Ostrava, The Czech Republic, during the COVID-19 pandemic, from March 20, 2020, until May 24, 2021.
RESULTS: The relationship between the extravascular lung water index and alveolar-arterial oxygen difference showed only a mild-to-moderate correlation (r = 0.33, P < .001). Other extravascular lung water index correlations were as follows: 
(r = 0.33, P < .001), end-tidal oxygen concentration (r = 0.26, P = .0032), 
minus end-tidal oxygen concentration (r = 0.15, P = .0624), and 
(r = –0.15, P = .01).
CONCLUSIONS: The alveolar-arterial oxygen difference does not reliably correlate with the extravascular lung water index and the degree of lung edema in COVID-19–associated ARDS.
- COVID-19
- alveolar-arterial difference
- alveolar gas equation
- extravascular lung water index
- ARDS
- hypoxemia
- end-tidal O2
Footnotes
- Correspondence: Jan Maca MD, Department of Anaesthesiology and Intensive Care Medicine, University Hospital Ostrava 17, Listopadu 1790/5, Ostrava-Poruba, 708 52, The Czech Republic. E-mail: jan.maca{at}fno.cz
The authors have disclosed no conflicts of interest.
The study was performed at the Department of Anesthesiology and Intensive Care Medicine, University Hospital Ostrava, Ostrava, Czech Republic.
This research was supported by Specific University Research provided by the Ministry of Education Youth and Sports MUNI/A/1109/2022.
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