The effect of driving pressures in COVID-19 ARDS: Lower may still be better as in classic ARDS.


Journal

Respiratory investigation
ISSN: 2212-5353
Titre abrégé: Respir Investig
Pays: Netherlands
ID NLM: 101581124

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 19 12 2020
revised: 04 05 2021
accepted: 01 06 2021
pubmed: 11 7 2021
medline: 26 10 2021
entrez: 10 7 2021
Statut: ppublish

Résumé

The respiratory dynamics of coronavirus disease 2019 (COVID-19) patients under invasive ventilation are still not well known. In this prospective cohort, we aimed to assess the characteristics of the respiratory system in COVID-19 patients under invasive mechanical ventilation and evaluate their relationship with mortality. Fifty-eight COVID-19 patients who underwent invasive mechanical ventilation between March 11, 2020 and September 1, 2020 were enrolled for the present study. Demographics and laboratory values at baseline were recorded. Respiratory variables such as tidal volume, plateau pressure, positive end expiratory pressure, static compliance, and driving pressure were recorded daily under passive conditions. Further, the median values were analyzed. Median age of the patients was 64 years (58-72). Mortality was 60% on day 28. Plateau pressure, driving pressure, and static compliance significantly differ between the survivors and non-survivors. When patients were categorized into two groups based on the median driving pressure (Pdrive) of ≤15 cmH COVID-19 related acute respiratory distress syndrome (ARDS) seemed to have similar characteristics as other forms of ARDS. Lung protective ventilation with low plateau and driving pressures might be related to lower mortality.

Sections du résumé

BACKGROUND BACKGROUND
The respiratory dynamics of coronavirus disease 2019 (COVID-19) patients under invasive ventilation are still not well known. In this prospective cohort, we aimed to assess the characteristics of the respiratory system in COVID-19 patients under invasive mechanical ventilation and evaluate their relationship with mortality.
METHODS METHODS
Fifty-eight COVID-19 patients who underwent invasive mechanical ventilation between March 11, 2020 and September 1, 2020 were enrolled for the present study. Demographics and laboratory values at baseline were recorded. Respiratory variables such as tidal volume, plateau pressure, positive end expiratory pressure, static compliance, and driving pressure were recorded daily under passive conditions. Further, the median values were analyzed.
RESULTS RESULTS
Median age of the patients was 64 years (58-72). Mortality was 60% on day 28. Plateau pressure, driving pressure, and static compliance significantly differ between the survivors and non-survivors. When patients were categorized into two groups based on the median driving pressure (Pdrive) of ≤15 cmH
CONCLUSION CONCLUSIONS
COVID-19 related acute respiratory distress syndrome (ARDS) seemed to have similar characteristics as other forms of ARDS. Lung protective ventilation with low plateau and driving pressures might be related to lower mortality.

Identifiants

pubmed: 34244106
pii: S2212-5345(21)00110-6
doi: 10.1016/j.resinv.2021.06.002
pmc: PMC8258546
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

628-634

Informations de copyright

Copyright © 2021 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of Interest The authors have no conflicts of interest.

Auteurs

Süleyman Yildirim (S)

University of Health Sciences, Dr. Suat Seren Chest Disease and Chest Surgery Training and Research Hospital, Intensive Care Unit, İzmir, Turkey.

Burcu Acar Cinleti (BA)

University of Health Sciences, Dr. Suat Seren Chest Disease and Chest Surgery Training and Research Hospital, Intensive Care Unit, İzmir, Turkey.

Saba Mukaddes Saygili (SM)

University of Health Sciences, Dr. Suat Seren Chest Disease and Chest Surgery Training and Research Hospital, Intensive Care Unit, İzmir, Turkey.

Emre Senel (E)

University of Health Sciences, Dr. Suat Seren Chest Disease and Chest Surgery Training and Research Hospital, Intensive Care Unit, İzmir, Turkey.

Ozlem Ediboglu (O)

University of Health Sciences, Dr. Suat Seren Chest Disease and Chest Surgery Training and Research Hospital, Intensive Care Unit, İzmir, Turkey.

Cenk Kirakli (C)

University of Health Sciences, Dr. Suat Seren Chest Disease and Chest Surgery Training and Research Hospital, Intensive Care Unit, İzmir, Turkey. Electronic address: ckirakli@hotmail.com.

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