Abstract
<b>Introduction:</b> Heterogeneous respiratory system static compliance (CRS) values and levels of hypoxemia in patients with novel coronavirus disease (COVID-19) requiring mechanical ventilation have been reported in previous small-case series or studies conducted at a national level. <b>Methods:</b> We designed a retrospective observational cohort study with rapid data gathering from the international COVID-19 Critical Care Consortium study to comprehensively describe CRS – calculated as: tidal volume/[airway plateau pressure-positive end-expiratory pressure (PEEP)] – and its association with ventilatory management and outcomes of COVID-19 patients on mechanical ventilation (MV), admitted to intensive care units (ICU) worldwide. <b>Results:</b> We studied 745 patients from 22 countries, who required admission to the ICU and MV from January 14 to December 31, 2020, and presented at least one value of CRS within the first seven days of MV. Median (IQR) age was 62 (52-71), patients were predominantly males (68%) and from Europe/North and South America (88%). 28-day ICU mortality, accounting for the competing risk of being discharged within the period, was 35.6% (SE 1.7). Cox proportional hazard analysis demonstrated that CRS (+10 mL/cm H2O) was only associated with being discharge from the ICU within 28 days (HR 1.14, 95% CI 1.02 – 1.28, p=0.018). <b>Conclusions:</b> This multicentre report provides a comprehensive account of CRS in COVID-19 patients on MV. CRS measured within 48h from commencement of MV has marginal predictive value for 28-day mortality, but was associated with being discharged from ICU within the same period.
Highlights
Heterogeneous respiratory system static compliance (CRS) values and levels of hypoxemia in patients with novel coronavirus disease (COVID-19) requiring mechanical ventilation have been reported in previous smallcase series or studies conducted at a national level
Li Bassi et al Crit Care (2021) 25:199. This multicentre report provides a comprehensive account of Static respiratory system compliance (CRS) in COVID-19 patients on mechanical ventilation (MV)
CRS measured within 48 h from commencement of MV has marginal predictive value for 28-day mortality, but was associated with being discharged from intensive care unit (ICU) within the same period
Summary
Heterogeneous respiratory system static compliance (CRS) values and levels of hypoxemia in patients with novel coronavirus disease (COVID-19) requiring mechanical ventilation have been reported in previous smallcase series or studies conducted at a national level. They found that patients who presented with lower CRS and higher D-dimer values had the greatest mortality risk In line with these figures, in a small-case series, Chiumello and collaborators found that COVID-19 patients presented higher CRS levels in comparison with patients with ARDS from other etiologies and matched levels of hypoxemia [12]. Those previous reports did not provide any information on how CRS progressed beyond a punctual assessment during the period of MV. The authors found that intensive care unit (ICU) discharge and mortality were not influenced by the initial levels of CRS
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