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10.1186/s13054-020-03414-3

http://scihub22266oqcxt.onion/10.1186/s13054-020-03414-3
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33287864!7719729!33287864
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suck abstract from ncbi


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pmid33287864      Crit+Care 2020 ; 24 (1): 678
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  • Electrical impedance tomography to titrate positive end-expiratory pressure in COVID-19 acute respiratory distress syndrome #MMPMID33287864
  • Perier F; Tuffet S; Maraffi T; Alcala G; Victor M; Haudebourg AF; Razazi K; De Prost N; Amato M; Carteaux G; Mekontso Dessap A
  • Crit Care 2020[Dec]; 24 (1): 678 PMID33287864show ga
  • RATIONALE: Patients with coronavirus disease-19-related acute respiratory distress syndrome (C-ARDS) could have a specific physiological phenotype as compared with those affected by ARDS from other causes (NC-ARDS). OBJECTIVES: To describe the effect of positive end-expiratory pressure (PEEP) on respiratory mechanics in C-ARDS patients in supine and prone position, and as compared to NC-ARDS. The primary endpoint was the best PEEP defined as the smallest sum of hyperdistension and collapse. METHODS: Seventeen patients with moderate-to-severe C-ARDS were monitored by electrical impedance tomography (EIT) and evaluated during PEEP titration in supine (n = 17) and prone (n = 14) position and compared with 13 NC-ARDS patients investigated by EIT in our department before the COVID-19 pandemic. RESULTS: As compared with NC-ARDS, C-ARDS exhibited a higher median best PEEP (defined using EIT as the smallest sum of hyperdistension and collapse, 12 [9, 12] vs. 9 [6, 9] cmH(2)O, p < 0.01), more collapse at low PEEP, and less hyperdistension at high PEEP. The median value of the best PEEP was similar in C-ARDS in supine and prone position: 12 [9, 12] vs. 12 [10, 15] cmH(2)O, p = 0.59. The response to PEEP was also similar in C-ARDS patients with higher vs. lower respiratory system compliance. CONCLUSION: An intermediate PEEP level seems appropriate in half of our C-ARDS patients. There is no solid evidence that compliance at low PEEP could predict the response to PEEP.
  • |Adult[MESH]
  • |COVID-19/diagnostic imaging/*physiopathology[MESH]
  • |Electric Impedance/therapeutic use[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Positive-Pressure Respiration/instrumentation/*methods[MESH]
  • |Respiratory Distress Syndrome/*diagnostic imaging/physiopathology[MESH]
  • |Respiratory Mechanics/physiology[MESH]


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