About: Respiratory physiology of COVID-19-induced respiratory failure compared to ARDS of other etiologies

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About: Respiratory physiology of COVID-19-induced respiratory failure compared to ARDS of other etiologies Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Respiratory physiology of COVID-19-induced respiratory failure compared to ARDS of other etiologies
Creator	Chen, Lu Antonelli, Massimo De Pascale, Gennaro Brochard, Laurent Cutuli, Salvatore Urbani, Andrea Grieco, Domenico Maggiore, Salvatore Anzellotti, Gian Bello, Giuseppe Bocci, Maria Bongiovanni, Filippo Carelli, Simone Dell'anna, Antonio Lombardi, Gianmarco Menga, Luca Michi, Teresa Pintaudi, Gabriele Tanzarella, Eloisa Torrini, Flava
Source	Medline; PMC
abstract	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(2)O. A single-breath derecruitment maneuver was performed to assess recruitability. After 1:1 matching based on PaO(2)/FiO(2), FiO(2), PEEP, and tidal volume, COVID-19 patients were compared to subjects affected by ARDS of other etiologies who underwent the same procedures in a previous study. RESULTS: Thirty COVID-19 patients were successfully matched with 30 ARDS from other etiologies. At low PEEP, median [25th–75th percentiles] PaO(2)/FiO(2) in the two groups was 119 mmHg [101–142] and 116 mmHg [87–154]. Average compliance (41 ml/cmH(2)O [32–52] vs. 36 ml/cmH(2)O [27–42], p = 0.045) and ventilatory ratio (2.1 [1.7–2.3] vs. 1.6 [1.4–2.1], p = 0.032) were slightly higher in COVID-19 patients. Inter-individual variability (ratio of standard deviation to mean) of compliance was 36% in COVID-19 patients and 31% in other ARDS. In COVID-19 patients, PaO(2)/FiO(2) was linearly correlated with respiratory system compliance (r = 0.52 p = 0.003). High PEEP improved PaO(2)/FiO(2) in both cohorts, but more remarkably in COVID-19 patients (p = 0.005). Recruitability was not different between cohorts (p = 0.39) and was highly inter-individually variable (72% in COVID-19 patients and 64% in ARDS from other causes). In COVID-19 patients, recruitability was independent from oxygenation and respiratory mechanics changes due to PEEP. 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.
has issue date	2020-08-28(xsd:dateTime)
bibo:doi	10.1186/s13054-020-03253-2
bibo:pmid	32859264
has license	no-cc
sha1sum (hex)	cf6da8116d3748eab47ec497c80326b7c4bbc338
schema:url	https://doi.org/10.1186/s13054-020-03253-2
resource representing a document's title	Respiratory physiology of COVID-19-induced respiratory failure compared to ARDS of other etiologies
has PubMed Central identifier	PMC7453378
has PubMed identifier	32859264
schema:publication	Crit Care
resource representing a document's body	covid:cf6da8116d3748eab47ec497c80326b7c4bbc338#body_text
is schema:about of	named entity 'compare' named entity 'etiologies' named entity 'patients' named entity 'COVID-19' named entity 'COMPARED' named entity 'RESPIRATORY PHYSIOLOGY' named entity 'PATIENTS' named entity 'COVID-19' named entity 'etiologies' named entity 'respiratory failure' named entity 'based' named entity 'Italy' named entity 'ratio' named entity 'respiratory' named entity 'procedures' named entity 'COVID-19' named entity 'COVID-19 disease' named entity 'COVID' named entity 'body weight' named entity 'Physiological' named entity 'VILI' named entity 'tidal volume' named entity 'describe' named entity 'ARDS' named entity 'COVID-19' named entity 'etiologies' named entity 'PEEP' named entity 'COVID-19' named entity 'ARDS' named entity 'PEEP' named entity 'COVID-19' named entity 'clinical characteristics' named entity 'Fisher exact test' named entity 'ARDS' named entity 'COVID' named entity 'PEEP' named entity 'COVID-19' named entity 'PEEP' named entity 'COVID' named entity 'ARDS' named entity 'etiologies' named entity 'mechanical ventilation' named entity 'ARDS' named entity 'ARDS' named entity 'Categorical data' named entity 'COVID' named entity '0.51' named entity 'dead space' named entity 'ARDS' named entity 'ARDS' named entity 'lung' named entity 'PEEP' named entity 'ARDS' named entity 'alveolar' named entity 'etiologies' named entity 'alveoli' named entity 'COVID' named entity 'ventilator-induced lung injury' named entity '1.08' named entity 'PEEP' named entity 'PEEP' named entity 'physiology'

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