Programmed multi-level ventilation in COVID-19-related acute respiratory distress syndrome: a multi-center retrospective observational study
Autor: | Filip Depta, Pavol Török, Andrew G. Miller, Peter Firment, Jozef Leškanič, Adam Porubän, Pavol Halaš, Stanislav Mandinec, Vladimír Filka, Henryk Zajac, Michael A. Gentile, Marko Zdravkovic |
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Jazyk: | angličtina |
Rok vydání: | 2022 |
Předmět: | |
Zdroj: | Journal of International Medical Research, Vol 50 (2022) |
Druh dokumentu: | article |
ISSN: | 1473-2300 03000605 |
DOI: | 10.1177/03000605221101970 |
Popis: | Objective We evaluated pressure-controlled ventilation (PCV) with multiple programmed levels of positive end expiratory pressure (programmed multi-level ventilation; PMLV) in patients with coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome (ARDS). Methods We conducted a multicenter, retrospective study from November 2020 to February 2021. PMLV was used with PCV in all patients with intensive care admission until improvement in oxygenation (fraction of inspired oxygen [FiO 2 ] ≤0.50 and oxygen saturation [SpO 2 ] >92%). The observed outcomes were improvement of hypoxemia, length of mechanical ventilation, partial pressure of carbon dioxide (PaCO 2 ) stability, and adverse events. Results Of 188 mechanically ventilated patients with COVID-19-related ARDS, we analyzed 60 patients treated with PMLV. Hypoxemia improved in 55 (92%) patients, as measured by the change in partial pressure of oxygen/FiO 2 and SpO 2 /FiO 2 ratios on day 3 versus day 1, and in 32 (66%) ventilated patients on day 7 versus day 3. The median (interquartile range) length of mechanical ventilation for survivors and non-survivors was 8.4 (4.7–14.9) and 6.7 (3.6–10.3) days, respectively. Conclusions PMLV appears to be a safe and effective ventilation strategy for improving hypoxemia in patients with COVID-19-related ARDS. Further studies are needed comparing the PMLV mode with the conventional ARDS ventilatory approach. |
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