Background: This study aimed to compare ventilatory parameters recorded in the first days of acute respiratory distress syndrome (ARDS) and mortality at day 60 between coronavirus disease 2019 (COVID-19) and influenza ARDS patients with arterial oxygen tension ( )/inspiratory oxygen fraction ( ) ≤150 mmHg.
Methods: We compared 244 COVID-19 ARDS patients with 106 influenza ARDS patients. Driving pressure, respiratory system compliance ( ), ventilator ratio, corrected minute ventilation (') and surrogate of mechanical power (index=(4×driving pressure)+respiratory rate) were calculated from day 1 to day 5 of ARDS. A propensity score analysis and a principal component analysis (PCA) were performed.
Results: On day 1 of ARDS, COVID-19 patients had significantly higher / (median (interquartile range) 97 (79-129.2) 83 (62.2-114) mmHg; p=0.001), and lower driving pressure (13.0 (11.0-16.0) 14.0 (12.0-16.7) cmHO; p=0.01), ventilatory ratio (2.08 (1.73-2.49 2.52 (1.97-3.03); p<0.001), ' (12.7 (10.2-14.9) 14.9 (11.6-18.6) L·min; p<0.001) and index (80 (70-89) 84 (75-94); p=0.004). PCA demonstrated an important overlap of ventilatory parameters recorded on day 1 between the two groups. From day 1 to day 5, repeated values of / , arterial carbon dioxide tension, ventilatory ratio and ' differed significantly between influenza and COVID-19 patients in the unmatched and matched populations. Mortality at day 60 did not differ significantly after matching (29% 21.7%; p=0.43).
Conclusions: Ventilation was more impaired in influenza than in COVID-19 ARDS patients on the first day of ARDS with an important overlap of values. However, mortality at day 60 did not differ significantly in the matched population.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9885245 | PMC |
| http://dx.doi.org/10.1183/23120541.00554-2022 | DOI Listing |
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