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10.1164/rccm.202004-1412OC http://scihub22266oqcxt.onion/10.1164/rccm.202004-1412OC 32667207!7462405!32667207     free     free     free Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Am+J+Respir+Crit+Care+Med 2020 ; 202 (5): 690-699 Nephropedia Template TP {{tp|p=32667207|t=2020. Pulmonary Angiopathy in Severe COVID-19: Physiologic, Imaging, and Hematologic Observations |pdf=|usr=}}{{32667207}} gab.com Text Pulmonary Angiopathy in Severe COVID-19: Physiologic, Imaging, and Hematologic Observations JO: Am J Respir Crit Care Med http://www.kidney.de/pget.php?&tw=1&pmid=32667207 #FOAvip Rationale: Clinical and epidemiologic data in coronavirus disease (COVID-19) have accrued rapidly since the outbreak, but few address the underlying pathophysiology.Objectives: To ascertain the physiologic, hematologic, and imaging basis of lung injury in severe COVID-19 pneumonia.Methods: Clinical, physiologic, and laboratory data were collated. Radiologic (computed tomography (CT) pulmonary angiography [n = 39] and dual-energy CT [DECT, n = 20]) studies were evaluated: observers quantified CT patterns (including the extent of abnormal lung and the presence and extent of dilated peripheral vessels) and perfusion defects on DECT. Coagulation status was assessed using thromboelastography.Measurements and Results: In 39 consecutive patients (male:female, 32:7; mean age, 53 +/- 10 yr [range, 29-79 yr]; Black and minority ethnic, n = 25 [64%]), there was a significant vascular perfusion abnormality and increased physiologic dead space (dynamic compliance, 33.7 +/- 14.7 ml/cm H(2)O; Murray lung injury score, 3.14 +/- 0.53; mean ventilatory ratios, 2.6 +/- 0.8) with evidence of hypercoagulability and fibrinolytic "shutdown". The mean CT extent (+/-SD) of normally aerated lung, ground-glass opacification, and dense parenchymal opacification were 23.5 +/- 16.7%, 36.3 +/- 24.7%, and 42.7 +/- 27.1%, respectively. Dilated peripheral vessels were present in 21/33 (63.6%) patients with at least two assessable lobes (including 10/21 [47.6%] with no evidence of acute pulmonary emboli). Perfusion defects on DECT (assessable in 18/20 [90%]) were present in all patients (wedge-shaped, n = 3; mottled, n = 9; mixed pattern, n = 6).Conclusions: Physiologic, hematologic, and imaging data show not only the presence of a hypercoagulable phenotype in severe COVID-19 pneumonia but also markedly impaired pulmonary perfusion likely caused by pulmonary angiopathy and thrombosis. Twit Text FOAVip Pulmonary Angiopathy in Severe COVID-19: Physiologic, Imaging, and Hematologic Observations ????Am J Respir Crit Care Med http://www.kidney.de/pget.php?&tw=1&pmid=32667207 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=32667207 #FOAvip English Wikipedia <ref>{{Cite pmid|32667207}}</ref> Pulmonary Angiopathy in Severe COVID-19: Physiologic, Imaging, and Hematologic Observations #MMPMID32667207 Patel BV; Arachchillage DJ; Ridge CA; Bianchi P; Doyle JF; Garfield B; Ledot S; Morgan C; Passariello M; Price S; Singh S; Thakuria L; Trenfield S; Trimlett R; Weaver C; Wort SJ; Xu T; Padley SPG; Devaraj A; Desai SR Am J Respir Crit Care Med 2020[Sep]; 202 (5): 690-699 PMID32667207show ga Rationale: Clinical and epidemiologic data in coronavirus disease (COVID-19) have accrued rapidly since the outbreak, but few address the underlying pathophysiology.Objectives: To ascertain the physiologic, hematologic, and imaging basis of lung injury in severe COVID-19 pneumonia.Methods: Clinical, physiologic, and laboratory data were collated. Radiologic (computed tomography (CT) pulmonary angiography [n = 39] and dual-energy CT [DECT, n = 20]) studies were evaluated: observers quantified CT patterns (including the extent of abnormal lung and the presence and extent of dilated peripheral vessels) and perfusion defects on DECT. Coagulation status was assessed using thromboelastography.Measurements and Results: In 39 consecutive patients (male:female, 32:7; mean age, 53 +/- 10 yr [range, 29-79 yr]; Black and minority ethnic, n = 25 [64%]), there was a significant vascular perfusion abnormality and increased physiologic dead space (dynamic compliance, 33.7 +/- 14.7 ml/cm H(2)O; Murray lung injury score, 3.14 +/- 0.53; mean ventilatory ratios, 2.6 +/- 0.8) with evidence of hypercoagulability and fibrinolytic "shutdown". The mean CT extent (+/-SD) of normally aerated lung, ground-glass opacification, and dense parenchymal opacification were 23.5 +/- 16.7%, 36.3 +/- 24.7%, and 42.7 +/- 27.1%, respectively. Dilated peripheral vessels were present in 21/33 (63.6%) patients with at least two assessable lobes (including 10/21 [47.6%] with no evidence of acute pulmonary emboli). Perfusion defects on DECT (assessable in 18/20 [90%]) were present in all patients (wedge-shaped, n = 3; mottled, n = 9; mixed pattern, n = 6).Conclusions: Physiologic, hematologic, and imaging data show not only the presence of a hypercoagulable phenotype in severe COVID-19 pneumonia but also markedly impaired pulmonary perfusion likely caused by pulmonary angiopathy and thrombosis. |*Betacoronavirus[MESH] |Adult[MESH] |Aged[MESH] |COVID-19[MESH] |Coronavirus Infections/*complications/epidemiology[MESH] |Female[MESH] |Humans[MESH] |Lung/*blood supply/diagnostic imaging[MESH] |Male[MESH] |Middle Aged[MESH] |Pandemics[MESH] |Pneumonia, Viral/*complications/epidemiology[MESH] |Pulmonary Circulation/*physiology[MESH] |SARS-CoV-2[MESH] |Tomography, X-Ray Computed[MESH]Pulmonary Angiopathy in Severe COVID-19: Physiologic, Imaging, and Hem(epmc).pdf DeepDyve Pubget Overpricing