An appraisal of respiratory system compliance in mechanically ventilated COVID-19 patients

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Li Bassi, Gianluigi
Suen, Jacky
Dalton, Heidi J
White, Nicole
Sato, Kei
Shrapnel, Sally
Fanning, Jonathon P
Liquet, Benoit
Hinton, Samuel
Vuorinem, Aapeli
Booth, Gareth
Millar, Jonathan E
Forsyth, Simon
Corley, Amanda
Fraser, John
et al.
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2021
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Abstract

Introduction: Heterogeneous respiratory system static compliance (CRS) values and levels of hypoxemia in patients with novel coronavirus disease (COVID-19) requiring mechanical ventilation have been reported in previous small-case series or studies conducted at a national level. Methods: We designed a retrospective observational cohort study with rapid data gathering from the international COVID-19 Critical Care Consortium study to comprehensively describe CRS – calculated as: tidal volume/[airway plateau pressure-positive end-expiratory pressure (PEEP)] – and its association with ventilatory management and outcomes of COVID-19 patients on mechanical ventilation (MV), admitted to intensive care units (ICU) worldwide. Results: We studied 745 patients from 22 countries, who required admission to the ICU and MV from January 14 to December 31, 2020, and presented at least one value of CRS within the first seven days of MV. Median (IQR) age was 62 (52-71), patients were predominantly males (68%) and from Europe/North and South America (88%). 28-day ICU mortality, accounting for the competing risk of being discharged within the period, was 35.6% (SE 1.7). Cox proportional hazard analysis demonstrated that CRS (+10 mL/cm H2O) was only associated with being discharge from the ICU within 28 days (HR 1.14, 95% CI 1.02 – 1.28, p=0.018). Conclusions: This multicentre report provides a comprehensive account of CRS in COVID-19 patients on MV. CRS measured within 48h from commencement of MV has marginal predictive value for 28-day mortality, but was associated with being discharged from ICU within the same period.

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European Respiratory Journal

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ERS International Congress 2021 abstracts

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58

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Suppl. 65

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Subject

Respiratory diseases

Cardiovascular medicine and haematology

Science & Technology

Life Sciences & Biomedicine

Respiratory System

Covid-19

Acute respiratory failure

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Li Bassi, G; Suen, J; Dalton, HJ; White, N; Sato, K; Shrapnel, S; Fanning, JP; Liquet, B; Hinton, S; Vuorinem, A; Booth, G; Millar, JE; Forsyth, S; Corley, A; Fraser, JF; et al., An appraisal of respiratory system compliance in mechanically ventilated COVID-19 patients, European Respiratory Journal, 2021, 58 (Suppl. 65), PA3318