- Standard lung-protective ventilatory strategies may suffice for patients with COVID-19 and acute respiratory distress syndrome (ARDS).
Why this matters
- Near-normal respiratory compliance has been reported in patients with COVID-19-positive ARDS.
- Whether ARDS resulting from COVID-19 calls for a nonstandard approach to mechanical ventilation has been a topic of debate.
- Compliance data were available in ~40%.
- Of those, 78% had low compliance; in more than one-third, it was severe.
- Median values were statistically comparable to those in large studies of patients with non-COVID ARDS:
- Baseline compliance of respiratory system (Crs), plateau pressure, driving pressure.
- 28-day all-cause mortality.
- Tidal volume, positive end-expiratory pressure (PEEP) did not vary with Crs, severity of lung disease.
- Median tidal volumes:
- Baseline: 6.9 (interquartile range [IQR], 6.3-7.8) mL/kg predicted body weight (PBW).
- Highest: 8.4 (IQR, 7.3-9.5) mL/kg PBW.
- Median PEEP:
- Baseline: 12 (IQR, 11-14) cmH2O.
- Highest: 14 (IQR, 12-15) cmH2O.
- Multicenter, prospective, observational study of patients with COVID-19 and ARDS undergoing mechanical ventilation at 36 Iberian ICUs in March and June, 2020 (n=742).
- Authors reported clinical features, ventilator settings, outcomes.
- Funding: Instituto de Salud Carlos III (Spain); Canadian Institutes of Health Research.
- Ventilatory strategies could not be linked to outcomes.