Abstract
Objective: We evaluated pressure-controlled ventilation (PCV) with multiple programmed levels of positive end expiratory pressure (programmed multi-level ventilation; PMLV) in patients with coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome (ARDS).
Methods: We conducted a multicenter, retrospective study from November 2020 to February 2021. PMLV was used with PCV in all patients with intensive care admission until improvement in oxygenation (fraction of inspired oxygen [FiO 2 ] ≤0.50 and oxygen saturation [SpO 2 ] >92%). The observed outcomes were improvement of hypoxemia, length of mechanical ventilation, partial pressure of carbon dioxide (PaCO 2 ) stability, and adverse events.
Results: Of 188 mechanically ventilated patients with COVID-19-related ARDS, we analyzed 60 patients treated with PMLV. Hypoxemia improved in 55 (92%) patients, as measured by the change in partial pressure of oxygen/FiO 2 and SpO 2 /FiO 2 ratios on day 3 versus day 1, and in 32 (66%) ventilated patients on day 7 versus day 3. The median (interquartile range) length of mechanical ventilation for survivors and non-survivors was 8.4 (4.7-14.9) and 6.7 (3.6-10.3) days, respectively.
Conclusions: PMLV appears to be a safe and effective ventilation strategy for improving hypoxemia in patients with COVID-19-related ARDS. Further studies are needed comparing the PMLV mode with the conventional ARDS ventilatory approach.
Keywords: Acute respiratory distress syndrome; coronavirus disease 2019; intensive care; mechanical ventilation; programmed multi-level ventilation; respiratory failure.
【저자키워드】 Coronavirus disease 2019, Respiratory failure, intensive care, acute respiratory distress syndrome, mechanical ventilation, programmed multi-level ventilation, 【초록키워드】 coronavirus disease, ARDS, Respiratory failure, Ventilation, oxygen, outcome, adverse events, Retrospective study, oxygen saturation, stability, Hypoxemia, Patient, multicenter, Admission, Intensive, patients, acute respiratory distress, distress, Safe, Oxygenation, interquartile range, syndrome, ventilatory, fraction, positive, survivor, approach, effective, non-survivor, expiratory, analyzed, was used, evaluated, conducted, median, appear, mechanically ventilated patient, patients treated, ventilated patient, 【제목키워드】 Ventilation, acute respiratory distress, retrospective,