Respiratory physiology of COVID-19-induced respiratory failure compared to ARDS of other etiologies.
Aged
Betacoronavirus
COVID-19
Coronavirus Infections
/ physiopathology
Female
Humans
Intensive Care Units
Italy
Male
Middle Aged
Pandemics
Pneumonia, Viral
/ physiopathology
Positive-Pressure Respiration
Respiratory Distress Syndrome
/ physiopathology
Respiratory Function Tests
Respiratory Mechanics
/ physiology
SARS-CoV-2
ARDS
Alveolar recruitment
COVID-19
PEEP
Respiratory mechanics
Journal
Critical care (London, England)
ISSN: 1466-609X
Titre abrégé: Crit Care
Pays: England
ID NLM: 9801902
Informations de publication
Date de publication:
28 08 2020
28 08 2020
Historique:
received:
12
06
2020
accepted:
17
08
2020
entrez:
30
8
2020
pubmed:
30
8
2020
medline:
4
9
2020
Statut:
epublish
Résumé
Whether respiratory physiology of COVID-19-induced respiratory failure is different from acute respiratory distress syndrome (ARDS) of other etiologies is unclear. We conducted a single-center study to describe respiratory mechanics and response to positive end-expiratory pressure (PEEP) in COVID-19 ARDS and to compare COVID-19 patients to matched-control subjects with ARDS from other causes. Thirty consecutive COVID-19 patients admitted to an intensive care unit in Rome, Italy, and fulfilling moderate-to-severe ARDS criteria were enrolled within 24 h from endotracheal intubation. Gas exchange, respiratory mechanics, and ventilatory ratio were measured at PEEP of 15 and 5 cmH Thirty COVID-19 patients were successfully matched with 30 ARDS from other etiologies. At low PEEP, median [25th-75th percentiles] PaO Early after establishment of mechanical ventilation, COVID-19 patients follow ARDS physiology, with compliance reduction related to the degree of hypoxemia, and inter-individually variable respiratory mechanics and recruitability. Physiological differences between ARDS from COVID-19 and other causes appear small.
Sections du résumé
BACKGROUND
Whether respiratory physiology of COVID-19-induced respiratory failure is different from acute respiratory distress syndrome (ARDS) of other etiologies is unclear. We conducted a single-center study to describe respiratory mechanics and response to positive end-expiratory pressure (PEEP) in COVID-19 ARDS and to compare COVID-19 patients to matched-control subjects with ARDS from other causes.
METHODS
Thirty consecutive COVID-19 patients admitted to an intensive care unit in Rome, Italy, and fulfilling moderate-to-severe ARDS criteria were enrolled within 24 h from endotracheal intubation. Gas exchange, respiratory mechanics, and ventilatory ratio were measured at PEEP of 15 and 5 cmH
RESULTS
Thirty COVID-19 patients were successfully matched with 30 ARDS from other etiologies. At low PEEP, median [25th-75th percentiles] PaO
CONCLUSIONS
Early after establishment of mechanical ventilation, COVID-19 patients follow ARDS physiology, with compliance reduction related to the degree of hypoxemia, and inter-individually variable respiratory mechanics and recruitability. Physiological differences between ARDS from COVID-19 and other causes appear small.
Identifiants
pubmed: 32859264
doi: 10.1186/s13054-020-03253-2
pii: 10.1186/s13054-020-03253-2
pmc: PMC7453378
doi:
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
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