Longitudinal changes in compliance, oxygenation and ventilatory ratio in COVID-19 versus non-COVID-19 pulmonary acute respiratory distress syndrome
| العنوان: | Longitudinal changes in compliance, oxygenation and ventilatory ratio in COVID-19 versus non-COVID-19 pulmonary acute respiratory distress syndrome |
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| المؤلفون: | Ferhat Meziani, Julien Demiselle, Nicolas Fage, Antoine Studer, Sibylle Cunat, Jean-Christophe Richard, Alain Mercat, François Beloncle, Satar Mortaza, Hamid Merdji, Laurent Brochard, Bertrand Pavlovsky, Christophe Desprez, Julie Helms, Valérie Seegers |
| المساهمون: | Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), MitoVasc - Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Strasbourg, Université de Strasbourg (UNISTRA), Integrated Center for Oncology [Angers] (ICO), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), LUNAM Université [Nantes Angers Le Mans], Regenerative NanoMedicine [Strasbourg] (RNM), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Fédération de Médecine Translationnelle de Strasbourg (FMTS), St. Michael's Hospital, University of Toronto, RICHARD, Jean-Christophe, Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC) |
| المصدر: | Critical Care, Vol 25, Iss 1, Pp 1-10 (2021) Critical Care Critical Care, 2021, 25 (1), pp.248. ⟨10.1186/s13054-021-03665-8⟩ Critical Care, BioMed Central, 2021, 25 (1), pp.248. ⟨10.1186/s13054-021-03665-8⟩ |
| بيانات النشر: | BMC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, ARDS, Letter, Coronavirus disease 2019 (COVID-19), [SDV]Life Sciences [q-bio], medicine.medical_treatment, Respiratory mechanics, Respiratory failure, Critical Care and Intensive Care Medicine, Severity of Illness Index, Body Mass Index, Positive-Pressure Respiration, 03 medical and health sciences, Dead space, 0302 clinical medicine, Mechanical ventilation, Medicine, Humans, 030212 general & internal medicine, Respiratory system, Propensity Score, Acute Respiratory Distress Syndrome, Aged, Respiratory Distress Syndrome, Pulmonary Gas Exchange, business.industry, SARS-CoV-2, RC86-88.9, Research, Medical emergencies. Critical care. Intensive care. First aid, Oxygenation, Middle Aged, medicine.disease, Respiration, Artificial, Respiratory Function Tests, [SDV] Life Sciences [q-bio], Compliance (physiology), Clinical trial, Intensive Care Units, 030228 respiratory system, Anesthesia, Female, Blood Gas Analysis, business, Covid-19, Body mass index |
| الوصف: | Background Differences in physiology of ARDS have been described between COVID-19 and non-COVID-19 patients. This study aimed to compare initial values and longitudinal changes in respiratory system compliance (CRS), oxygenation parameters and ventilatory ratio (VR) in patients with COVID-19 and non-COVID-19 pulmonary ARDS matched on oxygenation. Methods 135 patients with COVID-19 ARDS from two centers were included in a physiological study; 767 non-COVID-19 ARDS from a clinical trial were used for the purpose of at least 1:2 matching. A propensity-matching was based on age, severity score, oxygenation, positive end-expiratory pressure (PEEP) and pulmonary cause of ARDS and allowed to include 112 COVID-19 and 198 non-COVID pulmonary ARDS. Results The two groups were similar on initial oxygenation. COVID-19 patients had a higher body mass index, higher CRS at day 1 (median [IQR], 35 [28–44] vs 32 [26–38] ml cmH2O−1, p = 0.037). At day 1, CRS was correlated with oxygenation only in non-COVID-19 patients; 61.6% and 68.2% of COVID-19 and non-COVID-19 pulmonary ARDS were still ventilated at day 7 (p = 0.241). Oxygenation became lower in COVID-19 than in non-COVID-19 patients at days 3 and 7, while CRS became similar. VR was lower at day 1 in COVID-19 than in non-COVID-19 patients but increased from day 1 to 7 only in COVID-19 patients. VR was higher at days 1, 3 and 7 in the COVID-19 patients ventilated using heat and moisture exchangers compared to heated humidifiers. After adjustment on PaO2/FiO2, PEEP and humidification device, CRS and VR were found not different between COVID-19 and non-COVID-19 patients at day 7. Day-28 mortality did not differ between COVID-19 and non-COVID-19 patients (25.9% and 23.7%, respectively, p = 0.666). Conclusions For a similar initial oxygenation, COVID-19 ARDS initially differs from classical ARDS by a higher CRS, dissociated from oxygenation. CRS become similar for patients remaining on mechanical ventilation during the first week of evolution, but oxygenation becomes lower in COVID-19 patients. Trial registration: clinicaltrials.gov NCT04385004 |
| اللغة: | English |
| تدمد: | 1364-8535 0438-5004 1466-609X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dfb7b97a1c467f4a725a149778e8a4dbTest https://doaj.org/article/d8865fbee26d49d49969c5f7b910ae47Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....dfb7b97a1c467f4a725a149778e8a4db |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 13648535 04385004 1466609X |
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