TY - JOUR
T1 - An appraisal of respiratory system compliance in mechanically ventilated covid-19 patients
AU - Li Bassi, Gianluigi
AU - Suen, Jacky Y.
AU - Dalton, Heidi J.
AU - White, Nicole
AU - Shrapnel, Sally
AU - Fanning, Jonathon P.
AU - Liquet, Benoit
AU - Hinton, Samuel
AU - Vuorinen, Aapeli
AU - Booth, Gareth
AU - Millar, Jonathan E.
AU - Forsyth, Simon
AU - Panigada, Mauro
AU - Laffey, John
AU - Brodie, Daniel
AU - Fan, Eddy
AU - Torres, Antoni
AU - Chiumello, Davide
AU - Corley, Amanda
AU - Elhazmi, Alyaa
AU - Hodgson, Carol
AU - Ichiba, Shingo
AU - Luna, Carlos
AU - Murthy, Srinivas
AU - Nichol, Alistair
AU - Ng, Pauline Yeung
AU - Ogino, Mark
AU - Pesenti, Antonio
AU - Trieu, Huynh Trung
AU - Fraser, John F.
AU - the COVID-19 Critical Care Consortium
AU - Al-Dabbous, Tala
AU - Alfoudri, Huda
AU - Shamsah, Mohammed
AU - Elapavaluru, Subbarao
AU - Berg, Ashley
AU - Horn, Christina
AU - Schroll, Stephan
AU - Velazco, Jorge
AU - Fikes, Wanda
AU - Ploskanych, Ludmyla
AU - Meyer, Dan
AU - Shalabi-McGuire, Maysoon
AU - Witt, Trent
AU - Ehlers, Ashley
AU - Grazioli, Lorenzo
AU - Grandin, E. Wilson
AU - Nunez, Jose
AU - Reyes, Tiago
AU - Joseph, Mark
AU - Mitchell, Brook
AU - Tenzer, Martha
AU - Abe, Ryuzo
AU - Hayashi, Yosuke
AU - Cho, Hwa Jin
AU - Jeong, In Seok
AU - Brozzi, Nicolas
AU - Hernandez-Montfort, Jaime
AU - Mehkri, Omar
AU - Houltham, Stuart
AU - Graf, Jerónimo
AU - Perez, Rodrigo
AU - Diaz, Roderigo
AU - Delgado, Camila
AU - González, Joyce
AU - Sanchez, Maria Soledad
AU - Rincón, Diego Fernando Bautista
AU - Duque, Melissa Bustamante
AU - Yanten, Angela Maria Marulanda
AU - Brodie, Dan
AU - Rusmawatiningtyas, Desy
AU - Ragazzo, Gabrielle
AU - Taufik, Azhari
AU - Gunawan, Margaretha
AU - Irawany, Vera
AU - Rayhan, Muhammad
AU - Wardoyo, Elizabeth Yasmin
AU - Panigada, Mauro
AU - Coppola, Silvia
AU - Colombo, Sebastiano
AU - Grasselli, Giacomo
AU - Leone, Michela
AU - Zanella, Alberto
AU - Antonelli, Massimo
AU - Carelli, Simone
AU - Grieco, Domenico L.
AU - Asaki, Motohiro
AU - Hoshino, Kota
AU - Salazar, Leonardo
AU - Duarte, Laura
AU - McCaffrey, Joseph
AU - Bone, Allison
AU - Thomson, David
AU - Arnold-Day, Christel
AU - Cupido, Jerome
AU - Fanie, Zainap
AU - Miller, Malcom
AU - Seymore, Lisa
AU - van Straaten, Dawid
AU - Hassan, Ibrahim
AU - Hssain, Ali Ait
AU - Aliudin, Jeffrey
AU - Alqahtani, Al Reem
AU - Mohamed, Khoulod
AU - Mohamed, Ahmed
AU - Tan, Darwin
AU - Villanueva, Joy
AU - Zaqout, Ahmed
AU - Kurtzman, Ethan
AU - Ademi, Arben
AU - Dobrita, Ana
AU - Aoudi, Khadija El
AU - Segura, Juliet
AU - Giwangkancana, Gezy
AU - Ohshimo, Shinichiro
AU - Hoshino, Koji
AU - Hitoshi, Saito
AU - Uchinami, Yuka
AU - Osatnik, Javier
AU - Joosten, Anne
AU - Torres, Antoni
AU - Motos, Ana
AU - Yang, Minlan
AU - Luna, Carlos
AU - Arancibia, Francisco
AU - Williams, Virginie
AU - Noel, Alexandre
AU - Luque, Nestor
AU - Trung, Trieu Huynh
AU - Yacoub, Sophie
AU - Fantini, Marina
AU - García, Ruth Noemi Jorge
AU - Alvarez, Enrique Chicote
AU - Greti, Anna
AU - Lomeli, Oscar
AU - Ceccato, Adrian
AU - Sanchez, Angel
AU - Vazquez, Ana Loza
AU - Roche-Campo, Ferran
AU - Tuazon, Divina
AU - Duculan, Toni
AU - Shimizu, Hiroaki
AU - Amato, Marcelo
AU - Cassimiro, Luciana
AU - Pola, Flavio
AU - Ribeiro, Francis
AU - Fonseca, Guilherme
AU - Dalton, Heidi
AU - Desai, Mehul
AU - Osborn, Erik
AU - Deeb, Hala
AU - Arcadipane, Antonio
AU - Bianco, Claudia
AU - Cuffaro, Raffaele
AU - Martucci, Gennaro
AU - Occhipinti, Giovanna
AU - Rossetti, Matteo
AU - Vitiello, Chiara
AU - Cho, Sung Min
AU - Calligy, Kate
AU - Whitman, Glenn
AU - Shimizu, Hiroaki
AU - Moriyama, Naoki
AU - Kim, Jae Burm
AU - Kitamura, Nobuya
AU - Shimazui, Takashi
AU - Al-Hudaib, Abdullah
AU - Elhazmi, Alyaa
AU - Gebauer, Johannes
AU - Yokoyama, Toshiki
AU - Al-Fares, Abdulrahman
AU - Alamad, Esam
AU - Alawadhi, Fatma
AU - Alawadi, Kalthoum
AU - Buabbas, Sarah
AU - Tanaka, Hiro
AU - Hashimoto, Satoru
AU - Yamazaki, Masaki
AU - Oh, Tak Hyuck
AU - Epler, Mark
AU - Forney, Cathleen
AU - Feister, Jared
AU - Grobengieser, Katherine
AU - Kruse, Louise
AU - Williamson, Joelle
AU - Gnall, Eric
AU - Caroline, Mara
AU - Golden, Sasha
AU - Karaj, Colleen
AU - McDermott, Sherry
AU - Sher, Lynn
AU - Shapiro, Timothy
AU - Thome, Lisa
AU - Vanderland, Mark
AU - Welch, Mary
AU - Brazzi, Luca
AU - Ogston, Tawnya
AU - Nagpal, Dave
AU - Fischer, Karlee
AU - Lorusso, Roberto
AU - de Piero, Maria
AU - Esperatti, Mariano
AU - O’Briain, Diarmuid
AU - Carton, Edmund G.
AU - Sen, Ayan
AU - Palacios, Amanda
AU - Rainey, Deborah
AU - Seefeldt, Cassandra
AU - Durham, Lucia
AU - Falcucci, Octavio
AU - Emmrich, Amanda
AU - Guy, Jennifer
AU - Johns, Carling
AU - Neumann, Emily
AU - Buchtele, Nina
AU - Schwameis, Michael
AU - Stecher, Stephanie Susanne
AU - Singh, Delila
AU - Barnikel, Michaela
AU - Arenz, Lukas
AU - Zaaqoq, Akram
AU - Galloway, Lan Anh
AU - Merley, Caitlin
AU - Csete, Marc
AU - Quesada, Luisa
AU - Saba, Isabela
AU - Kasugai, Daisuke
AU - Hiraiwa, Hiroaki
AU - Tanaka, Taku
AU - Marwali, Eva
AU - Purnama, Yoel
AU - Dewayanti, Santi Rahayu
AU - Ardiyan,
AU - Siagian, Debby
AU - Chen, Yih Sharng
AU - Laffey, John
AU - McNicholas, Bairbre
AU - Cosgrave, David
AU - VanDyk, Marlice
AU - MacDonald, Sarah
AU - Seppelt, Ian
AU - Ratsep, Indrek
AU - Johnson, Hannah
AU - Barrett, Peter
AU - Salt, Gavin
AU - Ng, George
AU - Lee, Sang Min
AU - Smith, Timothy
AU - Holt, Rebecca
AU - Evans, Timothy
AU - Rose, Rebecca
N1 - Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2021
Y1 - 2021
N2 - Background: Heterogeneous respiratory system static compliance (CRS) values and levels of hypoxemia in patients with novel coronavirus disease (COVID-19) requiring mechanical ventilation have been reported in previous small-case series or studies conducted at a national level. Methods: We designed a retrospective observational cohort study with rapid data gathering from the international COVID-19 Critical Care Consortium study to comprehensively describe CRS—calculated as: tidal volume/[airway plateau pressure-positive end-expiratory pressure (PEEP)]—and its association with ventilatory management and outcomes of COVID-19 patients on mechanical ventilation (MV), admitted to intensive care units (ICU) worldwide. Results: We studied 745 patients from 22 countries, who required admission to the ICU and MV from January 14 to December 31, 2020, and presented at least one value of CRS within the first seven days of MV. Median (IQR) age was 62 (52–71), patients were predominantly males (68%) and from Europe/North and South America (88%). CRS, within 48 h from endotracheal intubation, was available in 649 patients and was neither associated with the duration from onset of symptoms to commencement of MV (p = 0.417) nor with PaO2/FiO2 (p = 0.100). Females presented lower CRS than males (95% CI of CRS difference between females-males: − 11.8 to − 7.4 mL/cmH2O p < 0.001), and although females presented higher body mass index (BMI), association of BMI with CRS was marginal (p = 0.139). Ventilatory management varied across CRS range, resulting in a significant association between CRS and driving pressure (estimated decrease − 0.31 cmH2O/L per mL/cmH20 of CRS, 95% CI − 0.48 to − 0.14, p < 0.001). Overall, 28-day ICU mortality, accounting for the competing risk of being discharged within the period, was 35.6% (SE 1.7). Cox proportional hazard analysis demonstrated that CRS (+ 10 mL/cm H2O) was only associated with being discharge from the ICU within 28 days (HR 1.14, 95% CI 1.02–1.28, p = 0.018). Conclusions: This multicentre report provides a comprehensive account of CRS in COVID-19 patients on MV. CRS measured within 48 h from commencement of MV has marginal predictive value for 28-day mortality, but was associated with being discharged from ICU within the same period. Trial documentation: Available at https://www.covid-critical.com/study. Trial registration: ACTRN12620000421932.
AB - Background: Heterogeneous respiratory system static compliance (CRS) values and levels of hypoxemia in patients with novel coronavirus disease (COVID-19) requiring mechanical ventilation have been reported in previous small-case series or studies conducted at a national level. Methods: We designed a retrospective observational cohort study with rapid data gathering from the international COVID-19 Critical Care Consortium study to comprehensively describe CRS—calculated as: tidal volume/[airway plateau pressure-positive end-expiratory pressure (PEEP)]—and its association with ventilatory management and outcomes of COVID-19 patients on mechanical ventilation (MV), admitted to intensive care units (ICU) worldwide. Results: We studied 745 patients from 22 countries, who required admission to the ICU and MV from January 14 to December 31, 2020, and presented at least one value of CRS within the first seven days of MV. Median (IQR) age was 62 (52–71), patients were predominantly males (68%) and from Europe/North and South America (88%). CRS, within 48 h from endotracheal intubation, was available in 649 patients and was neither associated with the duration from onset of symptoms to commencement of MV (p = 0.417) nor with PaO2/FiO2 (p = 0.100). Females presented lower CRS than males (95% CI of CRS difference between females-males: − 11.8 to − 7.4 mL/cmH2O p < 0.001), and although females presented higher body mass index (BMI), association of BMI with CRS was marginal (p = 0.139). Ventilatory management varied across CRS range, resulting in a significant association between CRS and driving pressure (estimated decrease − 0.31 cmH2O/L per mL/cmH20 of CRS, 95% CI − 0.48 to − 0.14, p < 0.001). Overall, 28-day ICU mortality, accounting for the competing risk of being discharged within the period, was 35.6% (SE 1.7). Cox proportional hazard analysis demonstrated that CRS (+ 10 mL/cm H2O) was only associated with being discharge from the ICU within 28 days (HR 1.14, 95% CI 1.02–1.28, p = 0.018). Conclusions: This multicentre report provides a comprehensive account of CRS in COVID-19 patients on MV. CRS measured within 48 h from commencement of MV has marginal predictive value for 28-day mortality, but was associated with being discharged from ICU within the same period. Trial documentation: Available at https://www.covid-critical.com/study. Trial registration: ACTRN12620000421932.
KW - Mechanical ventilation
KW - Compliance
KW - ARDS
KW - COVID-19
KW - SARS-CoV-2
UR - http://www.scopus.com/inward/record.url?scp=85107601543&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/arc/CE170100009
U2 - 10.1186/s13054-021-03518-4
DO - 10.1186/s13054-021-03518-4
M3 - Article
C2 - 34108029
AN - SCOPUS:85107601543
VL - 25
SP - 1
EP - 22
JO - Critical care (London, England)
JF - Critical care (London, England)
SN - 1364-8535
M1 - 199
ER -