Respiratory physiology of COVID-19-induced respiratory failure compared to ARDS of other etiologies

Grieco, Domenico Luca; Bongiovanni, Filippo; Chen, Lu; Menga, Luca S.; Cutuli, Salvatore Lucio; Pintaudi, Gabriele; Carelli, Simone; Michi, Teresa; Torrini, Flava; Lombardi, Gianmarco; Anzellotti, Gian Marco; De Pascale, Gennaro; Urbani, Andrea; Bocci, Maria Grazia; Tanzarella, Eloisa S.; Bello, Giuseppe; Dell’Anna, Antonio M.; Maggiore, Salvatore M.; Brochard, Laurent; Antonelli, Massimo

doi:10.1186/s13054-020-03253-2

Critical Care

Table 2 Respiratory mechanics

From: Respiratory physiology of COVID-19-induced respiratory failure compared to ARDS of other etiologies

	Low PEEP			High PEEP
	COVID-19	Non-COVID-19	p	COVID-19	Non-COVID-19	p
Set PEEP, cmH₂O	5 [5–5]*	5 [5–8]^§	0.031	15 [15–15]*	15 [15–18]^§	0.011
Total PEEP, cmH₂O	5 [5–6]*	8 [6–9]^§	< 0.001	15 [15–16]*	16 [15–18]^§	0.001
Tidal volume, ml	431 [395–473]	414 [370–443]	0.15	431 [395–473]	417 [357–445]	0.20
Tidal volume/PBW, ml/kg	6.4 [6–6.8]	6 [5.7–6.3]	0.037	6.4 [6–6.8]	6 [5.8–6.3]	0.036
Respiratory rate, breaths/minute	28 [26–30]	26 [24–30]	0.16	28 [26–30]	26 [24–30]	0.11
PaO₂/FiO₂, mmHg	119 [101–142]*	116 [87–154]^§	0.92	165 [132–196]*	150 [121–192]^§	0.049
pH	7.35 [7.29–7.42]	7.37 [7.33–7.40]	0.63	7.35 [7.32–7.42]	7.36 [7.32–7.40]	0.45
PaCO₂, mmHg	43 [37–49]	43 [37–49]	0.76	43 [36–49]	45 [35–49]	0.91
Ventilatory ratio	2.1 [1.7–2.3]	1.6 [1.4–2.1]	0.032	2.1 [1.7–2.4]	1.7 [1.4–2.2]	0.08
Standardized minute ventilation, liters/minute	12.4 [10.7–15.6]	11.1 [9.5–13.3]	0.12	12.4 [10.7–15.9]	11.5 [9.7–14.2]	0.29
Peak pressure, cmH₂O	29 [23–32]*	33 [29–39]^§	0.003	39 [36–41]*	41 [39–46]^§	0.043
Plateau pressure, cmH₂O	15 [14–17]*	19 [16–22]^§	< 0.001	26 [25–29]*	30 [28–33]^§	< 0.001
Inspiratory resistance, cmH₂O/liters/second	12 [10–14]	14 [11–16]^§	0.09	12 [10–14]	12 [10–14]^§	0.55
Driving pressure, cmH₂O	10 [8–12]	11 [9–13]^§	0.09	10 [9–14]	13 [11–17]^§	0.007
Patients with driving pressure ≤ 14 cmH₂O, no. (%)	24 (80)	25 (83)	1	24 (80)	21 (70)	0.55
Respiratory system compliance, ml/cmH₂O	41 [32–52]	36 [27–42]^§	0.045	39 [27–53]	32 [23–40]^§	0.003
Respiratory system compliance/PBW, ml/cmH₂O/kg	0.62 [0.48–0.78]	0.54 [0.46–0.63]^§	0.018	0.57 [0.45–0.75]	0.47 [0.37–0.56]^§	< 0.001
Arterial pressure, mmHg
Systolic	130 [112–140]*	124 [110–131]^§	0.27	118 [110–126]*	116 [104–126]^§	0.71
Diastolic	70 [57–80]	60 [55–64]	0.017	65 [54–70]	57 [54–62]	0.08
Heart rate, beats per minute	78 [70–93]	82 [74–101]	0.15	80 [70–92]	85 [75–103]	0.15

Data are expressed as medians [interquartile range], if not otherwise specified
*p < 0.05 for the comparison between low and high PEEP within the COVID-19 cohort
^§p < 0.05 for the comparison between low and high PEEP within the non-COVID-19 cohort

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