Primary Exposure and Outcomes:
The primary exposure was AVDSf at PARDS onset analyzed as a continuous variable. The primary outcome was RV systolic dysfunction as defined by abnormal RV GLS (dichotomous as defined above). Secondary outcomes included echocardiogram evidence of pulmonary hypertension and RV systolic dysfunction as defined by RV strain, TAPSE z-score, FAC, and qualitative assessments as well as measures of oxygenation including oxygenation index (OI = mPaw x FIO2 x 100 / PaO2) and PaO2/FiO2ratio.