Pulmonary pathophysiology development of COVID-19 assessed by serial Electrical Impedance Tomography in the MaastrICCht cohort

Autor: Serge J. H. Heines, Bas C. T. van Bussel, Melanie J. Acampo-de Jong, Frank C. Bennis, Rob J. J. van Gassel, Rald V. M. Groven, Nanon F. L. Heijnen, Ben J. M. Hermans, René Hounjet, Johan van Koll, Mark M. G. Mulder, Marcel C. G. van de Poll, Frank van Rosmalen, Ruud Segers, Sander Steyns, Ulrich Strauch, Jeanette Tas, Iwan C. C. van der Horst, Sander M. J. van Kuijk, Dennis C. J. J. Bergmans
Přispěvatelé: MUMC+: MA Arts Assistenten IC (9), MUMC+: MA Medische Staf IC (9), RS: CAPHRI - R5 - Optimising Patient Care, MUMC+: MA Heelkunde (9), Intensive Care, RS: NUTRIM - R2 - Liver and digestive health, Fysiologie, RS: Carim - H08 Experimental atrial fibrillation, RS: Carim - H01 Clinical atrial fibrillation, MUMC+: CCZ CTBM (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, MUMC+: MA Intensive Care (3), RS: Carim - V04 Surgical intervention, MUMC+: KIO Kemta (9), RS: CAPHRI - R2 - Creating Value-Based Health Care, MUMC+: MA Arts Assistenten IC (6)
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Scientific Reports, 12(1):14517. Nature Publishing Group
ISSN: 2045-2322
Popis: Patients with SARS-CoV-2 infection present with different lung compliance and progression of disease differs. Measures of lung mechanics in SARS-CoV-2 patients may unravel different pathophysiologic mechanisms during mechanical ventilation. The objective of this prospective observational study is to describe whether Electrical Impedance Tomography (EIT) guided positive end-expiratory pressure (PEEP) levels unravel changes in EIT-derived parameters over time and whether the changes differ between survivors and non-survivors. Serial EIT-measurements of alveolar overdistension, collapse, and compliance change in ventilated SARS-CoV-2 patients were analysed. In 80 out of 94 patients, we took 283 EIT measurements (93 from day 1–3 after intubation, 66 from day 4–6, and 124 from day 7 and beyond). Fifty-one patients (64%) survived the ICU. At admission mean PaO2/FiO2-ratio was 184.3 (SD 61.4) vs. 151.3 (SD 54.4) mmHg, (p = 0.017) and PEEP was 11.8 (SD 2.8) cmH2O vs. 11.3 (SD 3.4) cmH2O, (p = 0.475), for ICU survivors and non-survivors. At day 1–3, compliance was ~ 55 mL/cmH2O vs. ~ 45 mL/cmH2O in survivors vs. non-survivors. The intersection of overdistension and collapse curves appeared similar at a PEEP of ~ 12–13 cmH2O. At day 4–6 compliance changed to ~ 50 mL/cmH2O vs. ~ 38 mL/cmH2O. At day 7 and beyond, compliance was ~ 38 mL/cmH2O with the intersection at a PEEP of ~ 9 cmH2O vs. ~ 25 mL/cmH2O with overdistension intersecting at collapse curves at a PEEP of ~ 7 cmH2O. Surviving SARS-CoV-2 patients show more favourable EIT-derived parameters and a higher compliance compared to non-survivors over time. This knowledge is valuable for discovering the different groups.
Databáze: OpenAIRE
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