Logo image
Ventilated Patients With COVID-19 Show Airflow Obstruction
Journal article   Open access   Peer reviewed

Ventilated Patients With COVID-19 Show Airflow Obstruction

Vikas S. Koppurapu, Maksym Puliaiev, Kevin C. Doerschug and Gregory A. Schmidt
Journal of intensive care medicine, Vol.36(6), pp.696-703
06/01/2021
DOI: 10.1177/08850666211000601
PMCID: PMC8142384
PMID: 33706592
url
https://doi.org/10.1177/08850666211000601View
Published (Version of record) Open Access

Abstract

Objective: Many patients with coronavirus disease 2019 (COVID-19) need mechanical ventilation secondary to acute respiratory distress syndrome. Information on the respiratory system mechanical characteristics of this disease is limited. The aim of this study is to describe the respiratory system mechanical properties of ventilated COVID-19 patients. Design, Setting, and Patients: Patients consecutively admitted to the medical intensive care unit at the University of Iowa Hospitals and Clinics in Iowa City, USA, from April 19 to May 1, 2020, were prospectively studied; final date of follow-up was May 1, 2020. Measurements: At the time of first patient contact, ventilator information was collected including mode, settings, peak airway pressure, plateau pressure, and total positive end expiratory pressure. Indices of airflow resistance and respiratory system compliance were calculated and analyzed. Main Results: The mean age of the patients was 58 years. 6 out of 12 (50%) patients were female. Of the 21 laboratory-confirmed COVID-19 patients on invasive mechanical ventilation, 9 patients who were actively breathing on the ventilator were excluded. All the patients included were on volume-control mode. Mean [+/- standard deviation] ventilator indices were: resistive pressure 19 [+/- 4] cmH(2)O, airway resistance 20 [+/- 4] cmH(2)O/L/s, and respiratory system static compliance 39 [+/- 16] ml/cmH(2)O. These values are consistent with abnormally elevated resistance to airflow and reduced respiratory system compliance. Analysis of flow waveform graphics revealed a pattern consistent with airflow obstruction in all patients. Conclusions: Severe respiratory failure due to COVID-19 is regularly associated with airflow obstruction.
Critical Care Medicine General & Internal Medicine Life Sciences & Biomedicine Science & Technology

Details

Metrics

Logo image