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Background: The comparison of respiratory system compliance (C) between COVID and non-COVID ARDS patients has been the object of debate, but few studies have evaluated it when considering applied positive end expiratory pressure (PEEP), which is one of the known determinants of C itself. The aim of this study was to compare C taking into account the applied PEEP.
Methods: Two cohorts of patients were created: those with COVID-ARDS and those with non-COVID ARDS. In the whole sample the association between C and type of ARDS at different PEEP levels was adjusted for anthropometric and clinical variables. As secondary analyses, patients were matched for predicted functional residual capacity and the same association was assessed. Moreover, the association between C and type of ARDS was reassessed at predefined PEEP level of 0, 5, 10, and 15 cmHO with a propensity score-weighted linear model.
Results: 367 patients were included in the study, 276 patients with COVID-ARDS and 91 with non-COVID ARDS. The association between C and type of ARDS was not significant in both the complete cohorts (p = 0.17) and in the matched cohorts (p = 0.92). This was true also for the propensity score weighted association at PEEP 5, 10 and 15 cmHO, while it was statistically significant at PEEP 0 (with a median difference of 3 ml/cmHO, which in our opinion is not clinically significant).
Conclusions: The compliance of the respiratory system is similar between COVID ARDS and non-COVID ARDS when calculated at the same PEEP level and while taking into account patients' anthropometric characteristics.
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http://dx.doi.org/10.1186/s12931-022-01930-0 | DOI Listing |
J Bras Pneumol
December 2024
. Centro de Terapia Intensiva, Hospital Moinhos de Vento, Porto Alegre (RS) Brasil.
Objective: To compare pre-extubation physiological characteristics and ultrasound variables between patients intubated for COVID-19 compared to a clinical population and those intubated for other reasons.
Methods: This was a secondary analysis of a prospective cohort study of patients undergoing invasive mechanical ventilation (IMV) for more than 48 h. Patients were divided into two groups: those intubated for COVID-19-induced ARDS and those intubated for other clinical reasons.
Minerva Anestesiol
December 2024
Department of Health Science Anesthesia and ICU, School of Medicine, San Carlo Hospital, University of Basilicata, Potenza, Italy.
Front Med (Lausanne)
October 2024
Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Gistrup, Denmark.
Background: Acute respiratory distress syndrome (ARDS) is highly heterogeneous, both in its clinical presentation and in the patient's physiological responses to changes in mechanical ventilator settings, such as PEEP. This study investigates the clinical efficacy of a physiological model-based ventilatory decision support system (DSS) to personalize ventilator therapy in ARDS patients.
Methods: This international, multicenter, randomized, open-label study enrolled patients with ARDS during the COVID-19 pandemic.
Respir Care
October 2024
Drs Plasek, Ortega, Chuang, and Zhou and Ms Zhang and Mr Tan are affiliated with the Division of General Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Background: Lung-protective ventilation is a standard intervention for mitigating ventilator-induced lung injury in patients with ARDS. Despite its efficacy, adherence to contemporary evidence-based guidelines remains suboptimal. We aimed to identify factors that affect the adherence of staff to applying lung-protective ventilation guidelines by analyzing real-time, continuously monitored ventilation data over a 5-year longitudinal period.
View Article and Find Full Text PDFInt J Mol Sci
October 2024
First Department of Critical Care Medicine & Pulmonary Services, School of Medicine, National & Kapodistrian University of Athens, "Evangelismos" Hospital, 10676 Athens, Greece.
Endothelin-1 (ET-1) is a potent vasoconstrictor produced by endothelial cells and cleared from circulating blood mainly in the pulmonary vasculature. In a healthy pulmonary circulation, the rate of local production of ET-1 is less than its rate of clearance. In the present study, we aimed to investigate whether the abnormal pulmonary circulatory handling of ET-1 relates to poor clinical outcomes in patients with coronavirus disease 2019 (COVID-19)-induced acute respiratory distress syndrome (ARDS).
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