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Article Dans Une Revue Critical Care Année : 2021

Static compliance of the respiratory system in COVID-19 related ARDS: an international multicenter study

Benoit Vandenbunder
  • Fonction : Auteur
Michael Piagnerelli
  • Fonction : Auteur
Nicolas Serck
  • Fonction : Auteur
Thibaud Soumagne
  • Fonction : Auteur
Julien Textoris
Christophe Vinsonneau
  • Fonction : Auteur
Nadia Aissaoui
Gauthier Blonz
  • Fonction : Auteur
Giuseppe Carbutti
  • Fonction : Auteur
Romain Courcelle
  • Fonction : Auteur
Alain D’hondt
  • Fonction : Auteur
Stephane Gaudry
  • Fonction : Auteur
Julien Higny
  • Fonction : Auteur
Geoffroy Horlait
  • Fonction : Auteur
Sami Hraiech
  • Fonction : Auteur
Laurent Lefebvre
Francois Lejeune
  • Fonction : Auteur
Andre Ly
  • Fonction : Auteur
Jean-Baptiste Lascarrou
David Grimaldi

Résumé

Abstract Background Controversies exist on the nature of COVID-19 related acute respiratory distress syndrome (ARDS) in particular on the static compliance of the respiratory system (Crs). We aimed to analyze the association of Crs with outcome in COVID-19-associated ARDS, to ascertain its determinants and to describe its evolution at day-14. Methods In this observational multicenter cohort of patients with moderate to severe Covid-19 ARDS, Crs was measured at day-1 and day-14. Association between Crs or Crs/ideal body weight (IBW) and breathing without assistance at day-28 was analyzed with multivariable logistic regression. Determinants were ascertained by multivariable linear regression. Day-14 Crs was compared to day-1 Crs with paired t-test in patients still under controlled mechanical ventilation. Results The mean Crs in 372 patients was 37.6 ± 13 mL/cmH 2 O, similar to as in ARDS of other causes. Multivariate linear regression identified chronic hypertension, low PaO 2 /FiO 2 ratio, low PEEP, and low tidal volume as associated with lower Crs/IBW. After adjustment on confounders, nor Crs [OR 1.0 (CI 95% 0.98–1.02)] neither Crs/IBW [OR 0.63 (CI 95% 0.13–3.1)] were associated with the chance of breathing without assistance at day-28 whereas plateau pressure was [OR 0.93 (CI 95% 0.88–0.99)]. In a subset of 108 patients, day-14 Crs decreased compared to day-1 Crs (31.2 ± 14.4 mL/cmH 2 O vs 37.8 ± 11.4 mL/cmH 2 O, p < 0.001). The decrease in Crs was not associated with day-28 outcome. Conclusion In a large multicenter cohort of moderate to severe COVID-19 ARDS, mean Crs was decreased below 40 mL/cmH 2 O and was not associated with day-28 outcome. Crs decreased between day-1 and day-14 but the decrease was not associated with day-28 outcome.
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Dates et versions

hal-03518795 , version 1 (10-04-2024)

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Benoit Vandenbunder, Stephan Ehrmann, Michael Piagnerelli, Bertrand Sauneuf, Nicolas Serck, et al.. Static compliance of the respiratory system in COVID-19 related ARDS: an international multicenter study. Critical Care, 2021, 25 (1), pp.52. ⟨10.1186/s13054-020-03433-0⟩. ⟨hal-03518795⟩
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