In:
ERJ Open Research, European Respiratory Society (ERS), Vol. 9, No. 2 ( 2023-03), p. 00554-2022-
Abstract:
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 ( P aO 2 )/inspiratory oxygen fraction ( F IO 2 ) ≤150 mmHg. Methods We compared 244 COVID-19 ARDS patients with 106 influenza ARDS patients. Driving pressure, respiratory system compliance ( C rs ), ventilator ratio, corrected minute ventilation ( V ′ Ecorr ) 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 P aO 2 / F IO 2 (median (interquartile range) 97 (79–129.2) versus 83 (62.2–114) mmHg; p=0.001), and lower driving pressure (13.0 (11.0–16.0) versus 14.0 (12.0–16.7) cmH 2 O; p=0.01), ventilatory ratio (2.08 (1.73–2.49 versus 2.52 (1.97–3.03); p 〈 0.001), V ′ Ecorr (12.7 (10.2–14.9) versus 14.9 (11.6–18.6) L·min −1 ; p 〈 0.001) and index (80 (70–89) versus 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 P aO 2 / F IO 2 , arterial carbon dioxide tension, ventilatory ratio and V ′ Ecorr 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% versus 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.
Type of Medium:
Online Resource
ISSN:
2312-0541
DOI:
10.1183/23120541.00554-2022
DOI:
10.1183/23120541.00554-2022.Supp1
Language:
English
Publisher:
European Respiratory Society (ERS)
Publication Date:
2023
detail.hit.zdb_id:
2827830-6
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