Abstract

Background

Data on respiratory mechanics of COVID-19 ARDS patients are scarce. Respiratory mechanics and response to positive expiratory pressure (PEEP) may be different in obese and non-obese patients.

Methods

We investigated esophageal pressure allowing determination of transpulmonary pressures (PL ) and elastances (EL) during a decremental PEEP trial from 20 to 6 cm H2O in a cohort of COVID-19 ARDS patients.

Results

Fifteen patients were investigated, 8 obese and 7 non-obese patients. PEEP ≥ 16 cm H2O for obese patients and PEEP ≥10 cm H2O for non-obese patients were necessary to obtain positive expiratory PL. Change of PEEP did not alter significantly ΔPL or elastances in obese patients. However, in non-obese patients lung EL  and ΔPL increased significantly with PEEP increase. Chest wall EL was not affected by PEEP variations in both groups.

Details

Title
Transpulmonary pressures in obese and non-obese COVID-19 ARDS
Author
Mezidi Mehdi 1 ; Daviet Florence 2 ; Chabert, Paul 3 ; Hraiech Sami 2 ; Bitker Laurent 4 ; Forel Jean-Marie 2 ; Yonis Hodane 3 ; Gragueb Ines 5 ; Dhelft Francois 3 ; Papazian, Laurent 2 ; Jean-Christophe, Richard 4 ; Guervilly Christophe 2   VIAFID ORCID Logo 

1  Medical ICU, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France (GRID:grid.413306.3) (ISNI:0000 0004 4685 6736); Lyon 1 University, Lyon, France (GRID:grid.413306.3) 
2  Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, Chemin Des Bourrely, Marseille, France (GRID:grid.414244.3) (ISNI:0000 0004 1773 6284); Aix-Marseille Université, Faculté de médecine, Centre d’Etudes et de Recherches sur les Services de Santé et qualité de vie EA 3279, Marseille, France (GRID:grid.5399.6) (ISNI:0000 0001 2176 4817) 
3  Medical ICU, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France (GRID:grid.413306.3) (ISNI:0000 0004 4685 6736) 
4  Medical ICU, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France (GRID:grid.413306.3) (ISNI:0000 0004 4685 6736); Lyon 1 University, Lyon, France (GRID:grid.413306.3); CREATIS, CNRS UMR5220, INSERM U1044, INSA, Lyon, France (GRID:grid.15399.37) (ISNI:0000 0004 1765 5089) 
5  Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, Chemin Des Bourrely, Marseille, France (GRID:grid.414244.3) (ISNI:0000 0004 1773 6284) 
Publication year
2020
Publication date
Dec 2020
Publisher
Springer Nature B.V.
e-ISSN
21105820
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s13613-020-00745-w
ProQuest document ID
2449450081
Copyright
© The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.