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- Title
Ventilatory Parameters Measured After One Week of Mechanical Ventilation and Survival in COVID-19--Related ARDS.
- Authors
Leatherman, James W.; Prekker, Matthew E.; Kummer, Rebecca L.; Maurer, John L.; Beacom, Evan J.; Ahiskali, Aileen S.; Shapiro, Robert S.
- Abstract
BACKGROUND: Ventilatory parameters measured soon after initiation of mechanical ventilation have limited ability to predict outcome of COVID-19-related ARDS. We hypothesized that ventilatory parameters measured after one week of mechanical ventilation might differ between survivors and non-survivors. METHODS: One hundred twenty-seven subjects with COVID-related ARDS had gas exchange and lung mechanics assessed on the day of intubation and one week later. The main parameters of interest were ..., ventilatory ratio (VR), respiratory system compliance (CRS), and a composite score that was calculated as (...) x CRS/VR. The primary outcome was death in the ICU. RESULTS: Of the 127 subjects, 42 (33%) died in the ICU and 85 (67%) were successfully extubated. On the day of intubation, ..., CRS, and composite score of survivors and non-survivors were similar, but survivors had a lower VR. At one week, as compared to survivors, non-survivors had a significantly higher VR (2.04 ± 0.76 vs 1.60 ± 0.43, P < .001), lower CRS (27.4 ± 6.4 mL/cm H2O vs 32.4 ± 9.3 mL/cm H2O, P = .002), and lower composite score (20.6 ± 11.9 vs 34.5 ± 18.6, P < .001), with no statistically significant difference in ... (137 ± 49 vs 155 ± 48, P = .08). CONCLUSIONS: In subjects with COVID ARDS, parameters that reflect dead space (VR), lung mechanics (CRS), and a combined score that included PaO2 /FIO2, VR, and CRS differed between survivors and non-survivors after one week of mechanical ventilation but with considerable overlap of values between survivors and non-survivors.
- Subjects
COVID-19; CONFIDENCE intervals; RETROSPECTIVE studies; ARTERIAL pressure; ARTIFICIAL respiration; ADULT respiratory distress syndrome; DATA analysis software; ODDS ratio; RECEIVER operating characteristic curves; BODY mass index; PARTIAL pressure
- Publication
Respiratory Care, 2023, Vol 68, Issue 1, p44
- ISSN
0020-1324
- Publication type
Article
- DOI
10.4187/respcare.10029