Please use this identifier to cite or link to this item: doi:10.22028/D291-36764
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Title: Pulmonary Hemodynamics and Ventilation in Patients With COVID-19-Related Respiratory Failure and ARDS
Author(s): Becker, André
Seiler, Frederik
Muellenbach, Ralf M.
Danziger, Guy
Kamphorst, Maren
Lotz, Christopher
Bals, Robert
Lepper, Philipp M.
Language: English
Title: Journal of Intensive Care Medicine
Volume: 36
Issue: 6
Pages: 655-663
Publisher/Platform: Sage Science Press
Year of Publication: 2021
Free key words: acute respiratory distress syndrome
mechanical ventilation
novel coronavirus disease 2019
COVID-19
pulmonary artery catheter
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Background: It has been suggested that COVID-19-associated severe respiratory failure (CARDS) might differ from usual acute respiratory distress syndrome (ARDS) due to failing autoregulation of pulmonary vessels and higher shunt. We sought to investigate pulmonary hemodynamics and ventilation properties in patients with CARDS compared to patients with ARDS of pulmonary origin. Methods: This was a retrospective analysis of prospectively collected data from consecutive adults with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 patients treated in our ICU in 04/2020 and a comparison of the data to matched controls with ARDS due to respiratory infections treated in our ICU from 01/2014 to 08/2019 for whom pulmonary artery catheter data were available. Results: CARDS patients (n ¼ 10) had ventilation characteristics similar to those of ARDS (n ¼ 10) patients. Nevertheless, mechanical power applied by ventilation was significantly higher in CARDS patients (23.4 + 8.9 J/min) than in ARDS (15.9 + 4.3 J/min; P < 0.05). COVID-19 patients had similar pulmonary artery pressure but significantly lower pulmonary vascular resistance, as cardiac output was higher in CARDS vs. ARDS patients (P < 0.05). Shunt fraction and dead space were similar in CARDS compared to ARDS (P > 0.05) and were correlated with hypoxemia in both groups. The arteriovenous pCO2 difference (DpCO2) was elevated (CARDS 5.5 + 2.8 mmHg vs. ARDS 4.7 + 1.1 mmHg; P > 0.05), as was the P(v-a)CO2/C(a-v)O2 ratio (CARDS mean 2.2 + 1.5 vs. ARDS 1.7 + 0.8; P > 0.05). Conclusions: Respiratory failure in COVID-19 patients seems to differ only slightly from ARDS regarding ventilation characteristics and pulmonary hemodynamics. Our data indicate microcirculatory dysfunction. More data need to be collected to assure these findings and gain more pathophysiological insights into COVID-19 and respiratory failure.
DOI of the first publication: 10.1177/0885066621995386
URL of the first publication: https://journals.sagepub.com/doi/10.1177/0885066621995386
Link to this record: urn:nbn:de:bsz:291--ds-367645
hdl:20.500.11880/33405
http://dx.doi.org/10.22028/D291-36764
ISSN: 1525-1489
0885-0666
Date of registration: 11-Jul-2022
Faculty: M - Medizinische Fakultät
Department: M - Innere Medizin
Professorship: M - Prof. Dr. Robert Bals
Collections:Die Universitätsbibliographie

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