An Appraisal of Respiratory System Compliance In Mechanically Ventilated Covid-19 Patients

Abstract Background Heterogeneous respiratory system static compliance (CRS) values and levels of hypoxemia in patients with novel coronavirus disease (COVID-19) requiring mechanical ventilation have been reported in previous small-case series or studies conducted at a national level. Methods We designed a retrospective observational cohort study with rapid data gathering from the international COVID-19 Critical Care Consortium study to comprehensively describe the impact of CRS on the ventilatory management and outcomes of COVID-19 patients on mechanical ventilation (MV), admitted to intensive care units (ICU) worldwide. Results We enrolled 318 COVID-19 patients enrolled into the study from January 14th through September 31th, 2020 in 19 countries and stratified into two CRS groups. CRS was calculated as: tidal volume/[airway plateau pressure-positive end-expiratory pressure (PEEP)] and available within 48 h from commencement of MV in 318 patients. Patients were mean ± SD of 58.0 ± 12.2, predominantly from Europe (54%) and males (68%). Median CRS (IQR) was 34.1 mL/cmH2O (26.5–45.5) and PaO2/FiO2 was 119 mmHg (87.1–164) and was not correlated with CRS. Female sex presented lower CRS than in males (95% CI: -13.8 to -8.5 P < 0.001) and higher body mass index (34.7 ± 10.9 vs 29.1 ± 6.0, p < 0.001). Median (IQR) PEEP was 12 cmH2O (10–15), throughout the range of CRS, while median (IQR) driving pressure was 12.3 (10–15) cmH2O and significantly decreased as CRS improved (p < 0.001). No differences were found in comorbidities and clinical management between CRS strata. In addition, 28-day ICU mortality and hospital mortality did not differ between CRS groups. Conclusions This multicentre report provides a comprehensive account of CRS in COVID-19 patients on MV – predominantly males or overweight females, in their late 50 s – admitted to ICU during the first international outbreaks. Phenotypes associated with different CRS upon commencement of MV could not be identified. Trial documentation: Available at https://www.covid-critical.com/study. Trial registration ACTRN12620000421932..

Medienart:	Preprint

Erscheinungsjahr:	2021
Erschienen:	2021

Enthalten in:	ResearchSquare.com - (2021) vom: 17. März Zur Gesamtaufnahme - year:2021

Sprache:	Englisch

Beteiligte Personen:

Bassi, Gianluigi Li [VerfasserIn] Suen, Jacky [VerfasserIn] Dalton, Heidi [VerfasserIn] White, Nicole [VerfasserIn] Shrapnel, Sally [VerfasserIn] Fanning, Jonathon P. [VerfasserIn] Liquet, Benoit [VerfasserIn] Hinton, Samuel [VerfasserIn] Vuorinem, Aapeli [VerfasserIn] Booth, Gareth [VerfasserIn] Millar, Jonathan [VerfasserIn] Forsyth, Simon [VerfasserIn] Panigada, Mauro [VerfasserIn] Laffey, John [VerfasserIn] Brodie, Daniel [VerfasserIn] Fan, Eddy [VerfasserIn] Torres, Antoni [VerfasserIn] Chiumello, Davide [VerfasserIn] Corley, Amanda [VerfasserIn] Elhazmi, Alyaa [VerfasserIn] Hodgson, Carol [VerfasserIn] Ichiba, Shingo [VerfasserIn] Luna, Carlos [VerfasserIn] Murthy, Srinivas [VerfasserIn] Nichol, Alistair [VerfasserIn] Yeung, Pauline [VerfasserIn] Ogino, Mark [VerfasserIn] Pesenti, Antonio [VerfasserIn] Trieu, Huynh Trung [VerfasserIn] Fraser, John [VerfasserIn]

Links:	Volltext [kostenfrei]

doi:	10.21203/rs.3.rs-125428/v1

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PPN (Katalog-ID):	XRA033594627