Publication: Assessment of Lung Reaeration at 2 Levels of Positive End-expiratory Pressure in Patients with Early and Late COVID-19-related Acute Respiratory Distress Syndrome
Issued Date
2021-09-01
Resource Type
ISSN
15360237
08835993
08835993
Other identifier(s)
2-s2.0-85108075909
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Thoracic Imaging. Vol.36, No.5 (2021), 286-293
Suggested Citation
Marry R. Smit, Ludo F.M. Beenen, Christel M.A. Valk, Milou M. De Boer, Maeke J. Scheerder, Jouke T. Annema, Frederique Paulus, Janneke Horn, Alexander P.J. Vlaar, Fabian O. Kooij, Markus W. Hollmann, Marcus J. Schultz, Lieuwe D.J. Bos Assessment of Lung Reaeration at 2 Levels of Positive End-expiratory Pressure in Patients with Early and Late COVID-19-related Acute Respiratory Distress Syndrome. Journal of Thoracic Imaging. Vol.36, No.5 (2021), 286-293. doi:10.1097/RTI.0000000000000600 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77923
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Assessment of Lung Reaeration at 2 Levels of Positive End-expiratory Pressure in Patients with Early and Late COVID-19-related Acute Respiratory Distress Syndrome
Abstract
Purpose: Patients with novel coronavirus disease (COVID-19) frequently develop acute respiratory distress syndrome (ARDS) and need invasive ventilation. The potential to reaerate consolidated lung tissue in COVID-19-related ARDS is heavily debated. This study assessed the potential to reaerate lung consolidations in patients with COVID-19-related ARDS under invasive ventilation. Materials and Methods: This was a retrospective analysis of patients with COVID-19-related ARDS who underwent chest computed tomography (CT) at low positive end-expiratory pressure (PEEP) and after a recruitment maneuver at high PEEP of 20 cm H2O. Lung reaeration, volume, and weight were calculated using both CT scans. CT scans were performed after intubation and start of ventilation (early CT), or after several days of intensive care unit admission (late CT). Results: Twenty-eight patients were analyzed. The median percentages of reaerated and nonaerated lung tissue were 19% [interquartile range, IQR: 10 to 33] and 11% [IQR: 4 to 15] for patients with early and late CT scans, respectively (P=0.049). End-expiratory lung volume showed a median increase of 663 mL [IQR: 483 to 865] and 574 mL [IQR: 292 to 670] after recruitment for patients with early and late CT scans, respectively (P=0.43). The median decrease in lung weight attributed to nonaerated lung tissue was 229 g [IQR: 165 to 376] and 171 g [IQR: 81 to 229] after recruitment for patients with early and late CT scans, respectively (P=0.16). Conclusions: The majority of patients with COVID-19-related ARDS undergoing invasive ventilation had substantial reaeration of lung consolidations after recruitment and ventilation at high PEEP. Higher PEEP can be considered in patients with reaerated lung consolidations when accompanied by improvement in compliance and gas exchange.