| Autor: |
Gaetano, Scaramuzzo, Dan Stieper, Karbing, Alberto, Fogagnolo, Tommaso, Mauri, Elena, Spinelli, Matilde, Mari, Cecilia, Turrini, Federica, Montanaro, Carlo Alberto, Volta, Stephen Edward, Rees, Savino, Spadaro |
| Rok vydání: |
2022 |
| Zdroj: |
Respiratory care. |
| ISSN: |
1943-3654 |
| Popis: |
COVID-19-related ARDS is characterized by severe hypoxemia with initially preserved lung compliance and impaired ventilation/perfusion (V̇/Q̇) matching. PEEP can increase end-expiratory lung volume, but its effect on V̇/Q̇ mismatch in COVID-19-related ARDS is not clear.We enrolled intubated and mechanically ventilated subjects with COVID-19 ARDS and used the automatic lung parameter estimator (ALPE) to measure V̇/Q̇. Respiratory mechanics measurements, shunt, and V̇/Q̇ mismatch (low V̇/Q̇ and high V̇/Q̇) were collected at 3 PEEP levels (clinical PEEP = intermediate PEEP, low PEEP [clinical - 50%], and high PEEP [clinical + 50%]). A mixed-effect model was used to evaluate the impact of PEEP on V̇/Q̇. We also investigated if PEEP might have a different effect on V̇/Q̇ mismatch in 2 different respiratory mechanics phenotypes, that is, high elastance/low compliance (phenotype H) and low elastance/high compliance (phenotype L).Seventeen subjects with COVID-related ARDS age 66 [60-71] y with a PIn subjects with COVID-related ARDS placed on invasive mechanical ventilation for48 h, PEEP had a heterogeneous effect on V̇/Q̇ mismatch and, on average, higher levels were not able to reduce shunt. The subject's compliance could influence the effect of PEEP on V̇/Q̇ mismatch since an increased shunt was observed in subjects with lower compliance, whereas the opposite occurred in those with higher compliance. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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