• Humans
• Algorithms
• Intubation, Intratracheal/adverse effects
• Intubation, Intratracheal/methods
• Respiration, Artificial/methods
• Hypoxia/therapy
• Hypoxia/etiology
• Capnography

• Intensive care unit
• Point of care technology
• Therapeutic uses
• Training
• Transthoracic echocardiography
• Ultrasound

• Cardiopulmonary ultrasound
• Patent ductus arteriosus
• Preterm infants
• Respiratory failure

• Infant, Newborn
• Humans
• Infant, Premature
• Ductus Arteriosus, Patent/complications
• Ductus Arteriosus, Patent/diagnostic imaging
• Ductus Arteriosus, Patent/drug therapy
• Indomethacin/adverse effects
• Cyclooxygenase Inhibitors/adverse effects
• Infant, Low Birth Weight
• Prospective Studies
• Ibuprofen/therapeutic use
• Ibuprofen/adverse effects
• Ultrasonography
• Respiratory Insufficiency/diagnostic imaging
• Respiratory Insufficiency/etiology
• Respiratory Insufficiency/therapy
• Ultrasonography, Interventional

• LY20H040008 Natural Science Foundation of Zhejiang Province
• 2023KY164 Medical Science and Technology Project of Zhejiang Province

• echocardiography
• heart-lung interactions
• mechanical ventilation
• pulmonary edema
• weaning

• Cardiac output
• Echocardiography
• Ecocardiografía
• Gasto cardíaco
• Hemodynamic monitoring
• Integral velocidad-tiempo
• Monitorización hemodinámica
• Velocity time-integral

• Critical care cardiology
• Echocardiography
• Extracorporeal membrane oxygenation
• Mechanical circulatory support
• Point-of-care ultrasound

• COVID-19
• Coronavirus
• Doppler imaging
• Lung Ultrasound
• Pandemic
• Pneumothorax

Coronavirus disease 2019 (COVID-19) infection may trigger a multi-systemic disease involving different organs. There has been growing interest regarding the harmful effects of COVID-19 on the cardiovascular system. This systematic review aims to systematically analyze papers reporting echocardiographic findings in hospitalized COVID-19 subjects.

We included prospective and retrospective studies reporting echocardiography data in >10 hospitalized adult subjects with COVID-19; from 1st February 2020 to 15th January 2021.

The primary electronic search identified 1120 articles. Twenty-nine studies were finally included, enrolling 3944 subjects. Overall the studies included a median of 68.0% (45.5–100.0) of patients admitted to ICU. Ten studies (34.4%) were retrospective, and 20 (68.9%) single-centred. Overall enrolling 1367 subjects, three studies reported normal echocardiographic findings in 49 ± 18% of cases. Seven studies (24.1%) analyzed the association between echocardiographic findings and mortality, mostly related to right ventricular (RV) dysfunction.

Data regarding the use of echocardiography on hospitalized, predominantly ICU, COVID-19 patients were retrieved from studies with heterogeneous designs, variable sample sizes, and severity scores. Normal echocardiographic findings were reported in about 50% of subjects, with LVEF usually not affected. Overall, RV dysfunction seems more likely associated with increased mortality.

CRD42020218439.

• COVID-19
• Critical care
• Diastolic function
• Echocardiography
• Left ventricle
• Right ventricle
• Systolic function

• acute fatty liver of pregnancy
• multiple organ dysfunction syndrome
• severe acute pancreatitis

• Adult
• Fatty Liver/complications
• Fatty Liver/diagnosis
• Female
• Humans
• Liver/diagnostic imaging
• Liver Failure, Acute/diagnosis
• Liver Failure, Acute/etiology
• Liver Function Tests
• Multiple Organ Failure/diagnosis
• Multiple Organ Failure/etiology
• Pancreas/diagnostic imaging
• Pancreatitis/diagnosis
• Pancreatitis/etiology
• Pregnancy
• Pregnancy Complications/diagnosis
• Severity of Illness Index
• Stillbirth
• Tomography, X-Ray Computed

• COVID-19
• Emergency department
• Lung ultrasound
• Triage

• Adult
• COVID-19/diagnosis
• COVID-19/diagnostic imaging
• COVID-19 Testing/methods
• Emergency Service, Hospital
• Female
• Humans
• Lung/diagnostic imaging
• Male
• Middle Aged
• Pneumonia, Viral/diagnostic imaging
• Retrospective Studies
• Reverse Transcriptase Polymerase Chain Reaction
• SARS-CoV-2/isolation & purification
• Severity of Illness Index
• Tomography, X-Ray Computed

• 413517907 German Research Foundation

• COVID-19
• diagnosis
• emergency department
• point of care
• sensitivity and specificity
• ultrasound

• Sepsis
• echocardiography
• echocardiography, transesophageal
• monitoring
• septic
• shock

To assess the role of left ventricular overload and cumulated fluid balance in the development weaning-induced pulmonary edema (WIPO).

Ventilated patients in sinus rhythm with COPD and/or heart failure (ejection fraction ≤ 40%) were studied. Echocardiography was performed immediately before and during a 30-min spontaneous breathing trial (SBT) using a T-tube. Patients who failed were treated according to echocardiography results before undergoing a second SBT.

Twelve of 59 patients failed SBT, all of them developing WIPO. Patients who succeeded SBT had lower body weight (− 2.5 kg [− 4.8; − 1] vs. + 0.75 kg [− 2.95;  + 5.57]: p = 0.02) and cumulative fluid balance (− 2326 ml [− 3715;  + 863] vs. + 143 ml [− 2654; + 4434]: p = 0.007) than those who developed WIPO. SBT-induced central hemodynamic changes were more pronounced in patients who developed WIPO, with higher E wave velocity (122 cm/s [92; 159] vs. 93 cm/s [74; 109]: p = 0.017) and E/A ratio (2.1 [1.2; 3.6] vs. 0.9 [0.8; 1.4]: p = 0.001), and shorter E wave deceleration time (85 ms [72; 125] vs. 147 ms [103; 175]: p = 0.004). After echocardiography-guided treatment, all patients who failed the first SBT were successfully extubated. Fluid balance was then negative (− 2224 ml [− 7056; + 100] vs. + 146 ml [− 2654; + 4434]: p = 0.005). Left ventricular filling pressures were lower (E/E′: 7.3 [5; 10.4] vs. 8.9 [5.9; 13.1]: p = 0.028); SBT-induced increase in E wave velocity (+ 10.6% [− 2.7/ + 18] vs. + 25.6% [+ 12.7/ + 49]: p = 0.037) and of mitral regurgitation area were significantly smaller.

In high-risk patients, WIPO appears related to overloaded left ventricle associated with excessive fluid balance. SBT-induced central hemodynamic changes monitored by CCE help in guiding therapy for successful weaning.

The online version of this article (10.1007/s00134-020-06061-y) contains supplementary material, which is available to authorized users.

• Echocardiography
• Echocardiography Doppler
• Pulmonary edema
• Ventilator weaning
• Water-electrolyte balance

Although mechanical ventilation may be a patient’s vital ally during acute illness, it can quickly transform into an enemy during chronic conditions. The weaning process is the fundamental phase that enables the resumption of physiological respiratory function; however, it is also associated with a number of life-threatening complications, and a large percentage of critically ill patients never achieve airway device removal or require the resumption of mechanical ventilation just a few days post-weaning. Indeed, the weaning process is, at present, more of an art than a science. As such, there is urgent need for novel contributions from the scientific literature to abate the growing rates of morbidity and mortality associated with weaning failure. The physician attempting to wean a patient must integrate clinical parameters and common-sense criteria. Numerous studies have striven to identify single predictive factors of weaning failure and sought to standardize the weaning process, but the results are characterized by remarkable heterogeneity. Despite the lack of benchmarks, it is clear that the analysis of respiratory function must include a detailed overview of the five situations described below rather than a single aspect. The purpose of this two-part review is to provide a comprehensive description of these situations to clarify the “arena” physicians are entering when weaning critically ill patients from mechanical ventilation.

• Diaphragm
• Diaphragm dysfunction
• Echocardiography
• Mechanical ventilation
• Ultrasound
• Weaning

• Agreement
• Critical illness
• Intensive care unit
• Muscle thickness
• Quadriceps muscle
• Ultrasonography

• bedside US
• bronchiolitis
• pediatrics
• pneumonia
• thoracic US

• Child
• Child, Preschool
• Female
• Humans
• Infant
• Infant, Newborn
• Intensive Care Units, Pediatric
• Lung/diagnostic imaging
• Lung/pathology
• Lung Diseases/diagnostic imaging
• Lung Diseases/pathology
• Male
• Pneumonia/diagnostic imaging
• Pneumonia/pathology
• Prospective Studies
• Reproducibility of Results
• Sensitivity and Specificity
• Thoracic Cavity/diagnostic imaging
• Ultrasonography/methods

• Acute respiratory distress syndrome
• echocardiography
• lung ultrasound

• Echocardiography
• heart failure
• mechanical ventilation
• ventilator weaning

• children
• intensive care
• lung ultrasound
• point-of-care ultrasound
• sonographic artefact