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Transpulmonary pressures in obese and non-obese COVID-19 ARDS
Mehdi Mezidi1,2, Florence Daviet3,4, Paul Chabert1
1Medical ICU, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France.
Background:
Data on respiratory mechanics of COVID-19 ARDS patients are scarce. Respiratory mechanics and response to positive expiratory pressure (PEEP) may be different in obese and non-obese patients.
Methods:
We investigated esophageal pressure allowing determination of transpulmonary pressures (PL ) and elastances (EL) during a decremental PEEP trial from 20 to 6 cm H2O in a cohort of COVID-19 ARDS patients.
Results:
Fifteen patients were investigated, 8 obese and 7 non-obese patients. PEEP ≥ 16 cm H2O for obese patients and PEEP ≥10 cm H2O for non-obese patients were necessary to obtain positive expiratory PL. Change of PEEP did not alter significantly ΔPL or elastances in obese patients. However, in non-obese patients lung EL and ΔPL increased significantly with PEEP increase. Chest wall EL was not affected by PEEP variations in both groups.
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