by Vincent Bonny, Vincent Janiak, Savino Spadaro, Andrea
Pinna, Alexandre Demoule and Martin Dres
Critical Care volume 24,
Article number: 596 (2020) Published: 06
October 2020
Previous reports of severe acute respiratory syndrome
coronavirus 2 (SARS-Cov-2)-related acute respiratory distress syndrome (ARDS)
have been highlighting a profound hypoxemia and it is not yet well defined how
to set positive end-expiratory pressure (PEEP) in this context [1]. In this report, we describe the effects
of two levels of PEEP on lung mechanics using a multimodal approach.
Patients with confirmed laboratory SARS-Cov-2 infection and
meeting criteria for ARDS according to the Berlin definition [2] were eligible within the 48 h after
intubation. Written informed consent was waived due to the observational nature
of the study. The local ethic approved the study (N° CER-2020-16).
Patients were paralyzed and received lung protective
ventilation on volume-controlled ventilation. Effects of PEEP decremental were
evaluated at two levels of PEEP, arbitrarily 16 cm H2O and 8 cm H2O.
These levels were decided based on previous reports [3, 4]. Measurements were performed after 20 min
after changing the level of PEEP. Lung mechanics were assessed using an
esophageal catheter (NutriVentTM, Italy) [5]. Hemodynamics, indexed extravascular
lung water (EVLWi), pulmonary vascular permeability index (PVPI), and cardiac
function index (CFI) were monitored by transpulmonary thermodilution (TPTD)
device (PiCCO2, Pulsion Medical Systems, Germany). Pulmonary regional
ventilation was monitored by the use of an EIT belt placed around the patient’s
chest (PulmoVista500; Dräger Medical GmbH Lübeck, Germany) [6]…
1 comment:
Correction: https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-03392-6
Post a Comment