eISSN: 1731-2531
ISSN: 1642-5758
Anaesthesiology Intensive Therapy
Current issue Archive Manuscripts accepted About the journal Supplements Editorial board Reviewers Abstracting and indexing Subscription Contact Instructions for authors Publication charge Ethical standards and procedures
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
4/2022
vol. 54
 
Share:
Share:
abstract:
Original paper

Respiratory mechanics in late COVID-19 ARDS – a restrictive pattern is strongly associated with death. A cohort study

David Pestaña
1, 2
,
Luisa Maria Villar
3
,
Maria Gomez-Rojo
1
,
Garbiñe Roy
3
,
Borja Hinojal Olmedillo
1
,
Claudia Giménez
1
,
Paloma Zambrana
1
,
Gloria Guisado
1
,
Azucena Aláez
1
,
Tommaso Bardi
1, 2

  1. Department of Anaesthesia and Intensive Care, Hospital Universitario Ramon y Cajal, IRYCIS, Madrid, Spain
  2. Department of Health Science, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
  3. Department of Immunology, Hospital Universitario Ramon y Cajal, IRYCIS, Madrid, Spain
Anaesthesiol Intensive Ther 2022; 54, 4: 295–301
Online publish date: 2022/11/17
View full text Get citation
 
PlumX metrics:
Introduction
COVID-19 is associated with severe respiratory distress and high mortality. We investigated the evolution of the respiratory mechanics in COVID-19 acute respiratory distress syndrome (ARDS) and the occurrence of a restrictive respiratory pattern.

Material and methods
A retrospective, single-centre study including patients admitted to the ICU during the first wave of the pandemic (March-April 2020).

Results
A total of 141 consecutive patients were included. Many patients developed a restrictive pattern of respiratory mechanics during the course of the disease. Fifty-two patients died in the hospital (36.8%). In 29 cases (58% of the deceased) death was associated with a pattern of pulmonary mechanics, indicating a restrictive evolution of ARDS. Other diagnoses related to death were pulmonary embolism (n = 7, 14%), septic shock (n = 17, 33%), and other causes (n = 10, 20%), with some patients combining at least 2 of these diagnoses. In a multivariate analysis, age (OR = 1.06; 95% CI: 1.01–1.12; P = 0.029) and the administration of steroid pulses (OR = 2.7; 95% CI: 1.1–6.8; P = 0.03) were associated with the development of a restrictive pulmonary pattern and a higher level of plasmatic interleukin-6.

Conclusions
COVID-19 ARDS is associated with high mortality associated with a specific pattern of respiratory mechanics and sustained activation of innate immunological response. Age and administration of high-dose steroid pulses are associated with this clinical picture.

keywords:

COVID-19, adult, interleukins, restrictive lung disease, respiratory distress syndrome, respiration, artificial, late respiratory distress syndrome

Quick links
© 2024 Termedia Sp. z o.o.
Developed by Bentus.