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Inspiratory Airway Resistance in Respiratory Failure Due to COVID-19
Bijan Nezami1, Hai V Tran1, Kevin Zamora2
1Section of Pulmonary/Critical Care Medicine and Allergy/Immunology, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA.
Abstract:
To measure inspiratory airflow resistance in patients with acute respiratory distress syndrome (ARDS) due to COVID-19.
Design:
Observational cohort of a convenience sample.
Setting:
Three community ICUs.
Subjects:
Fifty-five mechanically ventilated patients with COVID-19.
Interventions:
Measurements of ventilatory mechanics during volume control ventilation.
Measurements:
Flow-time and pressure-time scalars were used to measure inspiratory airways resistance.
Results:
The median inspiratory airflow resistance was 12 cm H2O/L/s (interquartile range, 10-16). Inspiratory resistance was not significantly different among patients with asthma or chronic obstructive pulmonary disease compared with those without a history of obstructive airways disease (median 12.5 vs 12 cm H2O/L/s, respectively; p = 0.66). Survival to 90 days among patients with inspiratory resistance above 12 cm H2O/L/s was 68% compared with 60% for patients below 12 cm H2O/L/s (p = 0.58). Inspiratory resistance did not correlate with C-reactive protein, ferritin, Pao2/Fio2 ratio, or static compliance.
Conclusions:
Inspiratory airflow resistance was normal to slightly elevated among mechanically ventilated patients with ARDS due to COVID-19. Airways resistance was independent of a history of obstructive airways disease, did not correlate with biomarkers of disease severity, and did not predict mortality.
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