2021, Number 1
Hypoxemia and respiratory mechanics in patients with severe acute respiratory syndrome-coronavirus 2 infection
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ABSTRACTIntroduction: The SARS-CoV-2 pandemic has inspired new interest in the physiopathology of the acute respiratory distress syndrome (ARDS) due to COVID-19. This study describes the causes of hypoxemia and the respiratory mechanics in patients with COVID-19. Material and methods: Prospective unicentric cohort study. Patient data recorded from march 23rd till may 15th of 2020, we took basal data (comorbidities, laboratories and prognostic scales) and, ventilator and arterial blood gas data in patients aver 18 years of age which received mechanical ventilation (VM) due to COVID-19. We followed each patient for 15 days of mechanical ventilation. Results: A total of 50 patients, 13 were excluded due to incomplete data. The patients presented a mean of pulmonary compliance of 41.44 ± 12.18 mL/cmH2O, driving pressure (DP) 12.18 ± 2.67 cmH2O, tidal volume (Vt) 7.02 ± 1.11 mL/kg of predicted body weight, alveoloarterial gradient and PaO2/FiO2 relation 129 (48-309) mmHg. We ran a lineal repeated measure analysis to evaluate differences in mechanical ventilation on patients who where extubated early (Et) versus prolonged VM. With statistical significant differences with Vt and DP (p = 0.04, p = 0.0005 respectively) when they elevate more than 7.5 mL/kg y 13 cmH2O respectively. Conclusions: hypoxemia in mechanically ventilated patients due to augmented intrapulmonary shunts and ventilation/perfusion mismatch. In these patients throughout every day of VM, the Vt less than 7.5 mL/kg and DP less than 13 cmH2O.
Masi P, Bagate F, d'Humieres T, Al-Assaad L, Abou Chakra L, Derumeaux G, et al. Is hypoxemia explained by intracardiac or intrapulmonary shunt in COVID-19-related acute respiratory distress syndrome? Ann Intensive Care [Internet]. 2020;10(1):4-6. Available from: https://doi.org/10.1186/s13613-020-00726-z