Pathophysiology of COVID-19-associated acute respiratory distress syndrome: a multicentre prospective observational study
| Autor: | Letizia Di Meglio, Antonio Pesenti, Amedeo Guzzardella, Marco Di Laudo, Claudia Filippini, Lorenzo Querci, Franco Locatelli, Massimo Antonelli, Vittorio Scaravilli, Arthur S. Slutsky, Alfredo Lissoni, Giacomo Bellani, Luca Carsana, Stefano Nava, V. Marco Ranieri, Carmen Seccafico, Jean Louis Vincent, Gianpaolo Carrafiello, Chiara Rizzuto, Francesco Monteduro, Maurizio Cecconi, Roberto Fumagalli, Domenico Luca Grieco, N Rossi, John G. Laffey, Massimo Girardis, Alberto Zanella, Gennaro De Pascale, Giacinto Pizzilli, Tommaso Tonetti, Carlo Valsecchi, Giacomo Grasselli, Ezio Lanza, Alessandro Protti, Francesca Bevilacqua, Fabiana Madotto, Thomas Langer, Maurizio Zompatori |
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| Přispěvatelé: | Grasselli G., Tonetti T., Protti A., Langer T., Girardis M., Bellani G., Laffey J., Carrafiello G., Carsana L., Rizzuto C., Zanella A., Scaravilli V., Pizzilli G., Grieco D.L., Di Meglio L., de Pascale G., Lanza E., Monteduro F., Zompatori M., Filippini C., Locatelli F., Cecconi M., Fumagalli R., Nava S., Vincent J.-L., Antonelli M., Slutsky A.S., Pesenti A., Ranieri V.M., Lissoni A., Rossi N., Guzzardella A., Valsecchi C., Madotto F., Bevilacqua F., Di Laudo M., Querci L., Seccafico C., Grasselli, G, Tonetti, T, Protti, A, Langer, T, Girardis, M, Bellani, G, Laffey, J, Carrafiello, G, Carsana, L, Rizzuto, C, Zanella, A, Scaravilli, V, Pizzilli, G, Grieco, D, Di Meglio, L, de Pascale, G, Lanza, E, Monteduro, F, Zompatori, M, Filippini, C, Locatelli, F, Cecconi, M, Fumagalli, R, Nava, S, Vincent, J, Antonelli, M, Slutsky, A, Pesenti, A, Ranieri, V |
| Rok vydání: | 2020 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine ARDS medicine.medical_specialty Computed Tomography Angiography Dead space Pulmonary compliance Pathophysiology law.invention Fibrin Fibrinogen Degradation Products 03 medical and health sciences 0302 clinical medicine covid-19 acute respiratory distress syndrome sars-cov-2 law Settore MED/41 - ANESTESIOLOGIA Correspondence medicine Humans Prospective Studies 030212 general & internal medicine Respiratory system Lung Pandemics Aged Respiratory Distress Syndrome SARS-CoV-2 business.industry COVID-19 Articles COVID-19 ARDS D-dimer compliance Middle Aged medicine.disease Respiration Artificial Intensive care unit 030228 respiratory system Cohort Emergency medicine Female Observational study business |
| Zdroj: | The Lancet. Respiratory Medicine The Lancet Respiratory Medicine |
| ISSN: | 2213-2600 |
| DOI: | 10.1016/s2213-2600(20)30370-2 |
| Popis: | Background: Patients with COVID-19 can develop acute respiratory distress syndrome (ARDS), which is associated with high mortality. The aim of this study was to examine the functional and morphological features of COVID-19-associated ARDS and to compare these with the characteristics of ARDS unrelated to COVID-19. Methods: This prospective observational study was done at seven hospitals in Italy. We enrolled consecutive, mechanically ventilated patients with laboratory-confirmed COVID-19 and who met Berlin criteria for ARDS, who were admitted to the intensive care unit (ICU) between March 9 and March 22, 2020. All patients were sedated, paralysed, and ventilated in volume-control mode with standard ICU ventilators. Static respiratory system compliance, the ratio of partial pressure of arterial oxygen to fractional concentration of oxygen in inspired air, ventilatory ratio (a surrogate of dead space), and D-dimer concentrations were measured within 24 h of ICU admission. Lung CT scans and CT angiograms were done when clinically indicated. A dataset for ARDS unrelated to COVID-19 was created from previous ARDS studies. Survival to day 28 was assessed. Findings: Between March 9 and March 22, 2020, 301 patients with COVID-19 met the Berlin criteria for ARDS at participating hospitals. Median static compliance was 41 mL/cm H2O (33–52), which was 28% higher than in the cohort of patients with ARDS unrelated to COVID-19 (32 mL/cm H2O [25–43]; p |
| Databáze: | OpenAIRE |
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