Czech
Albanian
Arabic
Armenian
Azerbaijani
Belarusian
Bengali
Bosnian
Catalan
Czech
Danish
Deutsch
Dutch
English
Estonian
Finnish
Français
Greek
Haitian Creole
Hebrew
Hindi
Hungarian
Icelandic
Indonesian
Irish
Italian
Japanese
Korean
Latvian
Lithuanian
Macedonian
Mongolian
Norwegian
Persian
Polish
Portuguese
Romanian
Russian
Serbian
Slovak
Slovenian
Spanish
Swahili
Swedish
Turkish
Ukrainian
Vietnamese
Български
中文(简体)
中文(繁體)

COVID-19 and Deep Venous Thrombosis

Články mohou překládat pouze registrovaní uživatelé
Přihlášení Registrace
Odkaz je uložen do schránky
PostaveníDokončeno
Sponzoři
Jessa Hospital

Klíčová slova

Abstraktní

The aim of this study is to investigate the prevalence and possible risk factors of the occurrence of a DVT in 12 intubated and mechanically ventilated COVID-19 patients admitted to the ICU at a single time point (29/03/2020).

Popis

Patients admitted to the Intensive Care Unit (ICU) are known to be at risk for thrombo-embolic events. Virchow's triad describes the major risk factors in three categories: venous stasis, vessel injury and activation of blood coagulation. A prolonged mechanical ventilation together with the hemodynamic effects of this ventilation with a high positive and expiratory pressure (PEEP), the presence of central venous catheters, the immobilization of these patients and the presence of obesity or other comorbidities can attribute to the occurrence of a deep venous thrombosis (DVT) in patients admitted at ICU. The incidence of DVT during ICU stay has been reported between 5 and 15%.

On the 13th of March, the first COVID-19 patient was admitted at the ICU at the Jessa Hospital. Within a few days, the admissions at our COVID-19 unit grew exponential. In these difficult time, research concerning COVID-19 has been performed indicating the COVID-19 virus induces a hyper-inflammatory state. It has been suggested that systemic inflammation induces endothelial injury. This will activate the coagulation cascade and impair fibrinolysis with disruption of endothelial barrier, and loss of physiologic antithrombotic factors which may elevated the risk for DVTs significantly. Up to now, there is still no causal treatment for COVID-19. The current management of COVID-19 is mainly supportive i.e. a prolonged inflammatory status and a prolonged risk for VTE.

During the placement of a dialysis catheter in the femoral vein of one of the patients admitted in the ICU for COVID-19 at our hospital, a large deep vein thrombosis (DVT) proximal in both common femoral veins was noticed in a patient. Since there were no clinical signs of DVT present in this patient, every patient at the ICU unit at that moment was screened on the presence of DVTs. We found one or several deep vein thromboses in 8 out of 12 patients at 1 ICU unit. Since this was a unusual high incidence, we want to further investigate this prevalence and evaluate possible causes of these DVTs.

The aim of this study is to investigate the prevalence and possible risk factors of the occurrence of a DVT in 12 intubated and mechanically ventilated COVID-19 patients admitted to the ICU at a single time point (29/03/2020).

The endpoint of this cross-sectional study is to investigate the prevalence and identify possible risk factors of the occurrence of a DVT in these patients at the ICU.

These parameters are listed below and included parameters/values collected as a standard-of-care in our hospital:

- Demographics: i.e age, gender

- Comorbidities: smoking, hypertension, diabetes, cardiovascular disease, respiratory disease, malignancies, renal failure, liver failure, gastrointestinal disease, neurological conditions, mental state, other

- Symptoms at the time of admission to ICU: i.e fever, body temperature, dyspnoea, headache, diarrhea etc…

- Laboratory results of all standard parameters measured

- Treatment: antiviral agents, antibiotics, etc…

- Complications: shock, heart failure, sepsis, stroke, etc…

- Ventilation: method, PEEP, FiO2, ..

- Radiological findings: pneumonia, ground-glass opacity..

Termíny

Poslední ověření: 04/30/2020
První předloženo: 04/06/2020
Odhadovaná registrace vložena: 04/06/2020
První zveřejnění: 04/07/2020
Poslední aktualizace byla odeslána: 05/15/2020
Poslední aktualizace zveřejněna: 05/18/2020
Aktuální datum zahájení studie: 04/16/2020
Odhadované datum dokončení primární: 05/14/2020
Odhadované datum dokončení studie: 05/14/2020

Stav nebo nemoc

COVID-19
Deep Vein Thrombosis (DVT)/Thrombophlebitis

Fáze

-

Kritéria způsobilosti

Věky způsobilé ke studiu 18 Years Na 18 Years
Pohlaví způsobilá ke studiuAll
Metoda vzorkováníProbability Sample
Přijímá zdravé dobrovolníkyAno
Kritéria

Inclusion Criteria:

- 12 intubated and mechanically ventilated COVID-19 patients admitted to the ICU at a single time point (29/03/2020).

Exclusion Criteria:

- None

Výsledek

Primární výsledná opatření

1. the prevalence of a DVT in patients at the ICU. [1 day at ICU]

to investigate the prevalence of a DVT in patients at the ICU.

Měření sekundárních výsledků

1. Oxygen partial pressure and Carbon dioxide partial pressure levels in the blood [1 day at ICU]

evaluate pO2 and pCO2 (mmHg) in patients with and without a DVT

2. Potassium, Sodium, Calcium, Bicarbonate, Base excess, Lactate levels in the blood [1 day at ICU]

evaluate Potassium, Sodium, Calcium, Bicarbonate, Base excess, Lactate levels (mmol/l) in patients with and without a DVT

3. glucose, haemoglobin, ureum, creatinine, total bilirubin levels in the blood [1 day at ICU]

evaluate glucose, haemoglobin, ureum, creatinine, total bilirubin levels (mg/dl) in patients with and without a DVT

4. oxygen saturation, basophils, eosinophils, monocytes, neutrophils, haematocrit and prothrombine levels in the blood [1 day at ICU]

evaluate oxygen saturation, basophils, eosinophils, monocytes, neutrophils, haematocrit and prothrombine levels in the blood (%) in patients with and without a DVT

5. white blood cells, red blood cells and platelets in the blood [1 day at ICU]

evaluate white blood cells (x 10*9/L), red blood cells (x 10*12/L) and platelets levels (x 109/L) in the blood in patients with and without a DVT

6. PT (%)aPTT (sec)Fibrinogen (g/L)D-dimers (mg/L) PT (INR) (ratio) AST (U/L)ALT (U/L)Lactate dehydrogenase (U/L)Troponin T (ng/L)CRP (mg/L)Ferritin (mg/L)in the blood [1 day at ICU]

evaluate PT (%)aPTT (sec)Fibrinogen (g/L)D-dimers (mg/L) PT (INR) (ratio) AST (U/L)ALT (U/L)Lactate dehydrogenase (U/L)Troponin T (ng/L)CRP (mg/L)Ferritin (mg/L) in the blood in patients with and without a DVT

7. prevalence of co-morbidities [1 day at ICU]

revalence of co morbidities such as Cardiovascular disease, n (%) Hypertension, n (%) Diabetes, n (%) Respiratory disease, n (%) Malignancy, n (%) Chronic renal disease, n (%) Chronic liver disease, n (%) Chronic bowel disease, n (%) Chronic nerve disease, n (%) Cerebrovascular disease, n (%) HIV/AIDS, n (%) Haematological disease, n (%) Obesity, n (%) Rheumatological disease, n (%) Dementia, n (%) in patients with and without a DVT admitted at the ICU in 1 day

8. prevalence of vital signs at icu admission [at ICU admission]

prevalence of vital signs such Temperature (°C) Breathing rate (#/min) Systolic blood pressure (mmHg) Mean arterial blood pressure (mmHg) Heart rate (#/min) Glasgow Coma Scale in patients with and without a DVT

9. prevalence of complications during icu stay [from ICU admission to cross sectional moment (29/3/2020)]

prevalance of complications such as ARDS Acute kidney failure Acute heart failure Septic shock Secondary infection Seizure Stroke Hyperglaecemia Hypoglaecemia during ICU stay in patients with and without DVT

10. evaluation of treatment [from ICU admission to cross sectional moment (29/3/2020)]

evaluation of treatment such as Antiviral treatment Antibiotic treatment Antifungal treatment Corticosteroid treatment CRRT IVIg treatment Plaquenil treatment during ICU stay in patients with and without DVT

11. evaluation of the oxygen therapy [from ICU admission to cross sectional moment (29/3/2020)]

evaluation of the oxygen therapy such as Invasive mechanical ventilation FiO2 (mmHg) PEEP Length of ventilationA ECMO Invasive mechanical ventilation + ECMO Vasopressor/inotropic support Neuromuscular blocking agents Prone ventilation in patients with and without DVT

Připojte se k naší
facebookové stránce

Nejúplnější databáze léčivých bylin podložená vědou

  • Funguje v 55 jazycích
  • Bylinné léky podporované vědou
  • Rozpoznávání bylin podle obrázku
  • Interaktivní mapa GPS - označte byliny na místě (již brzy)
  • Přečtěte si vědecké publikace související s vaším hledáním
  • Hledejte léčivé byliny podle jejich účinků
  • Uspořádejte své zájmy a držte krok s novinkami, klinickými testy a patenty

Zadejte symptom nebo chorobu a přečtěte si o bylinách, které by vám mohly pomoci, napište bylinu a podívejte se na nemoci a příznaky, proti kterým se používá.
* Všechny informace vycházejí z publikovaného vědeckého výzkumu

Google Play badgeApp Store badge